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Individual

MRS. CAMILLE VAN WAGONER HAWKINS

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
LCSW

Contact information

Practice address
12587 S FORT ST, DRAPER, UT 84020-9382
(801) 203-0244
Mailing address
1760 W 4805 S, TAYLORSVILLE, UT 84129-1177
(801) 487-0697

Taxonomy

Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
83776633502
UT

Other

Enumeration date
09/13/2012
Last updated
11/30/2022
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