Provider Demographics
NPI:1467524157
Name:HAWKES, SUSAN PATRICIA (SPEECH LANGUAGE PATH)
Entity Type:Individual
Prefix:MS
First Name:SUSAN
Middle Name:PATRICIA
Last Name:HAWKES
Suffix:
Gender:F
Credentials:SPEECH LANGUAGE PATH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:213 ROBINSON ST
Mailing Address - Street 2:EASTER SEALS OF RHODE ISLAND
Mailing Address - City:WAKEFIELD
Mailing Address - State:RI
Mailing Address - Zip Code:02879-3590
Mailing Address - Country:US
Mailing Address - Phone:401-284-1000
Mailing Address - Fax:401-284-1006
Practice Address - Street 1:213 ROBINSON ST
Practice Address - Street 2:EASTER SEALS OF RHODE ISLAND
Practice Address - City:WAKEFIELD
Practice Address - State:RI
Practice Address - Zip Code:02879
Practice Address - Country:US
Practice Address - Phone:401-284-1000
Practice Address - Fax:401-284-1006
Is Sole Proprietor?:No
Enumeration Date:2006-11-15
Last Update Date:2018-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
235Z00000X
RISP00340235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
RI232735OtherBCBS
RI4600113OtherUNITED HEALTHCARE
RI408266OtherBLUE CHIP
RI42240117OtherNEIGHBORHOOD HEALTH
RIKC02260Medicaid