Provider Demographics
NPI:1467418301
Name:HAWKINS, REBECCA S (PHD)
Entity Type:Individual
Prefix:
First Name:REBECCA
Middle Name:S
Last Name:HAWKINS
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4770 E ILIFF AVE STE 107
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80222-6049
Mailing Address - Country:US
Mailing Address - Phone:303-830-1181
Mailing Address - Fax:303-830-0270
Practice Address - Street 1:4770 E ILIFF AVE STE 107
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80222-6049
Practice Address - Country:US
Practice Address - Phone:303-830-1181
Practice Address - Fax:303-830-0270
Is Sole Proprietor?:No
Enumeration Date:2006-04-20
Last Update Date:2012-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO2582103G00000X, 103T00000X, 103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
No103G00000XBehavioral Health & Social Service ProvidersClinical Neuropsychologist
No103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
COP00675768Medicare PIN
COCO301726Medicare PIN