Provider Demographics
NPI:1326410036
Name:HAWKINS, LAKENDRIA (DC)
Entity Type:Individual
Prefix:DR
First Name:LAKENDRIA
Middle Name:
Last Name:HAWKINS
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:124 HARMONY VILLA WAY
Mailing Address - Street 2:
Mailing Address - City:SAINT PETERS
Mailing Address - State:MO
Mailing Address - Zip Code:63376-2890
Mailing Address - Country:US
Mailing Address - Phone:337-315-4264
Mailing Address - Fax:
Practice Address - Street 1:4122 KEATON CROSSING BLVD
Practice Address - Street 2:STE 105
Practice Address - City:O FALLON
Practice Address - State:MO
Practice Address - Zip Code:63368-8219
Practice Address - Country:US
Practice Address - Phone:636-224-8130
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-10-21
Last Update Date:2016-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2015004019111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor