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Individual

ANTONIO ANTWAN HAWTHORNE I

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
7300 AIRWAYS BLVD, SOUTHAVEN, MS 38671-5839
(662) 448-3232
(662) 490-3723
Mailing address
7300 AIRWAYS BLVD, SOUTHAVEN, MS 38671-5839
(662) 448-3232
(662) 490-3723

Taxonomy

Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
MS

Other

Enumeration date
11/24/2025
Last updated
11/24/2025
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