Provider Demographics
NPI:1265633606
Name:HAWBAKER, CHRISTIN DAWN (LAC)
Entity type:Individual
Prefix:MRS
First Name:CHRISTIN
Middle Name:DAWN
Last Name:HAWBAKER
Suffix:
Gender:F
Credentials:LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:175 E MAIN ST
Mailing Address - Street 2:
Mailing Address - City:CEDAREDGE
Mailing Address - State:CO
Mailing Address - Zip Code:81413-3331
Mailing Address - Country:US
Mailing Address - Phone:970-856-4729
Mailing Address - Fax:970-856-9999
Practice Address - Street 1:175 E MAIN ST
Practice Address - Street 2:
Practice Address - City:CEDAREDGE
Practice Address - State:CO
Practice Address - Zip Code:81413-3331
Practice Address - Country:US
Practice Address - Phone:970-856-4729
Practice Address - Fax:970-856-9999
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-31
Last Update Date:2018-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO927171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO927OtherSTATE OF COLORADO