Provider Demographics
NPI:1700553807
Name:HAKKER, ASHANTIE SHAKIERA
Entity Type:Individual
Prefix:
First Name:ASHANTIE
Middle Name:SHAKIERA
Last Name:HAKKER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1351 SPRINKLE DR
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32211-5448
Mailing Address - Country:US
Mailing Address - Phone:904-744-5110
Mailing Address - Fax:
Practice Address - Street 1:1351 SPRINKLE DR
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32211-5448
Practice Address - Country:US
Practice Address - Phone:904-744-5110
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-08-26
Last Update Date:2021-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst