Individual
LEASIE HAWKINS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1007 14TH AVE SW, DECATUR, AL 35601-2709
(256) 303-6030
Mailing address
1007 14TH AVE SW, DECATUR, AL 35601-2709
(256) 303-6030
Taxonomy
Speciality
Code
Description
License number
State
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
Primary
—
—
Other
Enumeration date
06/28/2023
Last updated
06/28/2023
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