Provider Demographics
NPI:1376760868
Name:HAWKINS, BROOKE ERIN (MCD, CF-SLP)
Entity Type:Individual
Prefix:
First Name:BROOKE
Middle Name:ERIN
Last Name:HAWKINS
Suffix:
Gender:F
Credentials:MCD, CF-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2208 FOWLER AVE
Mailing Address - Street 2:SUITE C
Mailing Address - City:JONESBORO
Mailing Address - State:AR
Mailing Address - Zip Code:72401-6115
Mailing Address - Country:US
Mailing Address - Phone:870-761-7612
Mailing Address - Fax:
Practice Address - Street 1:2208 FOWLER AVE
Practice Address - Street 2:SUITE C
Practice Address - City:JONESBORO
Practice Address - State:AR
Practice Address - Zip Code:72401-6115
Practice Address - Country:US
Practice Address - Phone:870-761-7612
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-04-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARSP#P8020235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist