Provider Demographics
NPI:1568590180
Name:HAWK, CARRIE (BS)
Entity Type:Individual
Prefix:
First Name:CARRIE
Middle Name:
Last Name:HAWK
Suffix:
Gender:F
Credentials:BS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1117
Mailing Address - Street 2:
Mailing Address - City:TULLAHOMA
Mailing Address - State:TN
Mailing Address - Zip Code:37388-1117
Mailing Address - Country:US
Mailing Address - Phone:931-808-7442
Mailing Address - Fax:
Practice Address - Street 1:607B S POLK ST
Practice Address - Street 2:
Practice Address - City:TULLAHOMA
Practice Address - State:TN
Practice Address - Zip Code:37388-3968
Practice Address - Country:US
Practice Address - Phone:931-461-1360
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor