Individual
MS. ROMA DEE HAWKINS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW 28701
Contact information
Practice address
1135 STANGER AVE, IDAHO FALLS, ID 83404-5523
(208) 681-4578
Mailing address
1135 STANGER AVE, IDAHO FALLS, ID 83404-5523
(208) 681-4578
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
28701
ID
Other
Enumeration date
10/25/2010
Last updated
10/25/2010
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