Provider Demographics
NPI:1477848968
Name:HAWKINS, DORIS JEAN
Entity Type:Individual
Prefix:
First Name:DORIS
Middle Name:JEAN
Last Name:HAWKINS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7311 E. SOUTHERN AVENUE #2061
Mailing Address - Street 2:
Mailing Address - City:MESA
Mailing Address - State:AZ
Mailing Address - Zip Code:85209
Mailing Address - Country:US
Mailing Address - Phone:520-275-7391
Mailing Address - Fax:520-296-8244
Practice Address - Street 1:7233 W RIVULET DR
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85743-8971
Practice Address - Country:US
Practice Address - Phone:520-744-8024
Practice Address - Fax:520-296-8244
Is Sole Proprietor?:Yes
Enumeration Date:2011-06-13
Last Update Date:2014-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ2577028385HR2055X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes385HR2055XRespite Care FacilityRespite CareRespite Care, Mental Illness, Child