Provider Demographics
NPI:1376357756
Name:HAWKINS, ALYSSA RENEE (BCBA)
Entity type:Individual
Prefix:MRS
First Name:ALYSSA
Middle Name:RENEE
Last Name:HAWKINS
Suffix:
Gender:F
Credentials:BCBA
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 251
Mailing Address - Street 2:
Mailing Address - City:SIMMS
Mailing Address - State:TX
Mailing Address - Zip Code:75574-0251
Mailing Address - Country:US
Mailing Address - Phone:907-854-8517
Mailing Address - Fax:
Practice Address - Street 1:2230 N EDWARDS AVE
Practice Address - Street 2:
Practice Address - City:MOUNT PLEASANT
Practice Address - State:TX
Practice Address - Zip Code:75455-2036
Practice Address - Country:US
Practice Address - Phone:907-854-8517
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-02-05
Last Update Date:2025-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX8066103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst