Provider Demographics
NPI:1831502640
Name:HAWKINS, SHANA M (COTA)
Entity Type:Individual
Prefix:
First Name:SHANA
Middle Name:M
Last Name:HAWKINS
Suffix:
Gender:F
Credentials:COTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:223 W WILSON ST
Mailing Address - Street 2:
Mailing Address - City:SALINA
Mailing Address - State:KS
Mailing Address - Zip Code:67401-5045
Mailing Address - Country:US
Mailing Address - Phone:785-798-0101
Mailing Address - Fax:
Practice Address - Street 1:200 WEST CEDAR
Practice Address - Street 2:SCHOWALTER RETIREMENT CENTER
Practice Address - City:HESSTON
Practice Address - State:KS
Practice Address - Zip Code:67062
Practice Address - Country:US
Practice Address - Phone:620-345-6735
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-06-09
Last Update Date:2014-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS18-01048224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant