Provider Demographics
NPI:1134281751
Name:HAWKINS, SUSAN (OTR)
Entity Type:Individual
Prefix:
First Name:SUSAN
Middle Name:
Last Name:HAWKINS
Suffix:
Gender:F
Credentials:OTR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2634 LAUREL TRAIL
Mailing Address - Street 2:
Mailing Address - City:ELLIJAY
Mailing Address - State:GA
Mailing Address - Zip Code:30536
Mailing Address - Country:US
Mailing Address - Phone:706-635-6396
Mailing Address - Fax:706-632-9756
Practice Address - Street 1:2634 LAUREL TRL
Practice Address - Street 2:
Practice Address - City:ELLIJAY
Practice Address - State:GA
Practice Address - Zip Code:30536-4105
Practice Address - Country:US
Practice Address - Phone:706-635-6396
Practice Address - Fax:706-632-9756
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-14
Last Update Date:2008-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist