Provider Demographics
NPI:1407133655
Name:HAWKINS, RAY DESHAWN II
Entity Type:Individual
Prefix:MR
First Name:RAY
Middle Name:DESHAWN
Last Name:HAWKINS
Suffix:II
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3925 N MARTIN LUTHER KING BLVD
Mailing Address - Street 2:208
Mailing Address - City:NORTH LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89032-7676
Mailing Address - Country:US
Mailing Address - Phone:702-265-7651
Mailing Address - Fax:702-490-6808
Practice Address - Street 1:3925 N MARTIN LUTHER KING BLVD
Practice Address - Street 2:208
Practice Address - City:NORTH LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89032-7676
Practice Address - Country:US
Practice Address - Phone:702-265-7651
Practice Address - Fax:702-490-6808
Is Sole Proprietor?:Yes
Enumeration Date:2011-11-15
Last Update Date:2011-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst