Organization
OLIVE TREE PLACE INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. LAURA BETH HAWKINS PMH-CNS (PSYCHIATRIC CLINICAL NURSE SPECIALI)
(765) 404-8317
Entity
Organization
Contact information
Practice address
2218 MAIN ST, SUITE E, LAFAYETTE, IN 47904-3614
(765) 446-1010
Mailing address
1411 W 500 S, LAFAYETTE, IN 47909-8146
(765) 404-8317
Taxonomy
Speciality
Code
Description
License number
State
364SP0808X
Psychiatric/Mental Health Clinical Nurse Specialist
Primary
28093092A
IN
Other
Enumeration date
04/24/2012
Last updated
04/24/2012
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