Provider Demographics
NPI:1376393348
Name:HAWKINS, ZEBULON MYDRAILL I (BA)
Entity Type:Individual
Prefix:
First Name:ZEBULON
Middle Name:MYDRAILL
Last Name:HAWKINS
Suffix:I
Gender:M
Credentials:BA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1502 S PECAN ST APT K
Mailing Address - Street 2:
Mailing Address - City:CORDELE
Mailing Address - State:GA
Mailing Address - Zip Code:31015-2101
Mailing Address - Country:US
Mailing Address - Phone:229-942-8614
Mailing Address - Fax:
Practice Address - Street 1:415 N JACKSON ST # 1348
Practice Address - Street 2:
Practice Address - City:AMERICUS
Practice Address - State:GA
Practice Address - Zip Code:31709-3015
Practice Address - Country:US
Practice Address - Phone:229-815-5454
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-03-25
Last Update Date:2024-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor