Provider Demographics
NPI:1437377371
Name:HAWKINS, KIESHA (OTR)
Entity Type:Individual
Prefix:MRS
First Name:KIESHA
Middle Name:
Last Name:HAWKINS
Suffix:
Gender:F
Credentials:OTR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13903 SARATOGA AVE
Mailing Address - Street 2:
Mailing Address - City:LAUREL
Mailing Address - State:MD
Mailing Address - Zip Code:20707-5822
Mailing Address - Country:US
Mailing Address - Phone:301-490-6476
Mailing Address - Fax:
Practice Address - Street 1:601 PENNSYLVANIA AVE NW
Practice Address - Street 2:STE. 900
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20004-2601
Practice Address - Country:US
Practice Address - Phone:301-292-8858
Practice Address - Fax:301-203-0993
Is Sole Proprietor?:No
Enumeration Date:2007-04-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCOT668225XP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics