Provider Demographics
NPI:1164996518
Name:HAWKING, ALESIA (OTR/L)
Entity Type:Individual
Prefix:
First Name:ALESIA
Middle Name:
Last Name:HAWKING
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1560 CENTRAL AVE UNIT 173
Mailing Address - Street 2:
Mailing Address - City:ST PETERSBURG
Mailing Address - State:FL
Mailing Address - Zip Code:33705-1615
Mailing Address - Country:US
Mailing Address - Phone:724-464-7801
Mailing Address - Fax:
Practice Address - Street 1:9085 TOWN CENTER PKWY
Practice Address - Street 2:
Practice Address - City:LAKEWOOD RANCH
Practice Address - State:FL
Practice Address - Zip Code:34202-4240
Practice Address - Country:US
Practice Address - Phone:941-549-8844
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-01-18
Last Update Date:2019-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOT18435225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist