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Individual

SALLY HAWKINS

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
OTR/L

Contact information

Practice address
11033 CATHELL RD, BERLIN, MD 21811-9328
(410) 208-3630
Mailing address
11546 S DOLLY CIR, BERLIN, MD 21811-3249
(410) 208-3630

Taxonomy

Speciality
Code
Description
License number
State
225XH1200X
Hand Occupational Therapist
Primary
02179
MD
225XH1200X
Hand Occupational Therapist
U10000904
DE

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
64125001
CAREFIRST INDIVIDUAL #
MD
01
754AAT
GROUP# CAREFIRST
MD
01
DC7481
RAIL ROAD MEDICARE GROUP
MD
01
J564
GROUP BLUE CHOICE/FEDERAL
MD
01
J564002
BLUE CHOICE/FEDERAL BLUE
MD
01
P00187997
RAIL ROAD MEDICARE
MD
Enumeration date
09/26/2006
Last updated
07/08/2007
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