Provider Demographics
NPI:1093860587
Name:FREY HAWKINS, JOANN PATRICE (LP)
Entity Type:Individual
Prefix:MS
First Name:JOANN
Middle Name:PATRICE
Last Name:FREY HAWKINS
Suffix:
Gender:F
Credentials:LP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:40700 CEDAR RIDGE RD
Mailing Address - Street 2:
Mailing Address - City:SAINT PETER
Mailing Address - State:MN
Mailing Address - Zip Code:56082-5346
Mailing Address - Country:US
Mailing Address - Phone:507-931-9172
Mailing Address - Fax:
Practice Address - Street 1:209 S 2ND ST
Practice Address - Street 2:SUITE 306
Practice Address - City:MANKATO
Practice Address - State:MN
Practice Address - Zip Code:56001-3626
Practice Address - Country:US
Practice Address - Phone:507-387-1350
Practice Address - Fax:507-387-6605
Is Sole Proprietor?:No
Enumeration Date:2007-01-24
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MNLP0414101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN114893OtherUCARE
MNHP28656OtherHEALTH PARTNERS
MN1021817OtherPREFERRED ONE
MN6H522FROtherBLUE CROSS
MN6245487OtherUNITED BEHAVORIAL HEALTH