Provider Demographics
NPI:1538651609
Name:HAWKINS, KELLI RENEE (RBT)
Entity Type:Individual
Prefix:MS
First Name:KELLI
Middle Name:RENEE
Last Name:HAWKINS
Suffix:
Gender:F
Credentials:RBT
Other - Prefix:MS
Other - First Name:KELLI
Other - Middle Name:RENEE
Other - Last Name:HOOKER-HAWKINS
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:RBT
Mailing Address - Street 1:8200 GEORGIA ST
Mailing Address - Street 2:
Mailing Address - City:MERRILLVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:46410-6227
Mailing Address - Country:US
Mailing Address - Phone:219-791-1400
Mailing Address - Fax:
Practice Address - Street 1:3675 CRESTWOOD PKWY NW STE 472
Practice Address - Street 2:
Practice Address - City:DULUTH
Practice Address - State:GA
Practice Address - Zip Code:30096-5136
Practice Address - Country:US
Practice Address - Phone:800-920-1927
Practice Address - Fax:330-550-8669
Is Sole Proprietor?:No
Enumeration Date:2018-06-04
Last Update Date:2021-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician