Provider Demographics
NPI:1114341476
Name:HAWKINS, ROBERTA LYNN (MA, BCBA, TXLBA)
Entity Type:Individual
Prefix:
First Name:ROBERTA
Middle Name:LYNN
Last Name:HAWKINS
Suffix:
Gender:F
Credentials:MA, BCBA, TXLBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3792 HIGH LONESOME
Mailing Address - Street 2:
Mailing Address - City:COLLEGE STATION
Mailing Address - State:TX
Mailing Address - Zip Code:77845-9400
Mailing Address - Country:US
Mailing Address - Phone:979-412-1423
Mailing Address - Fax:979-859-7168
Practice Address - Street 1:3792 HIGH LONESOME
Practice Address - Street 2:
Practice Address - City:COLLEGE STATION
Practice Address - State:TX
Practice Address - Zip Code:77845-9400
Practice Address - Country:US
Practice Address - Phone:979-412-1423
Practice Address - Fax:979-859-7168
Is Sole Proprietor?:No
Enumeration Date:2014-02-06
Last Update Date:2021-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
11314904103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst