Provider Demographics
NPI:1811312531
Name:HAWKINS, MARTA (M ED)
Entity type:Individual
Prefix:MRS
First Name:MARTA
Middle Name:
Last Name:HAWKINS
Suffix:
Gender:F
Credentials:M ED
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2350 POLE AVE
Mailing Address - Street 2:
Mailing Address - City:LORAIN
Mailing Address - State:OH
Mailing Address - Zip Code:44052-4301
Mailing Address - Country:US
Mailing Address - Phone:440-233-2242
Mailing Address - Fax:440-233-2341
Practice Address - Street 1:305 LOUISIANA AVE
Practice Address - Street 2:
Practice Address - City:LORAIN
Practice Address - State:OH
Practice Address - Zip Code:44052-2256
Practice Address - Country:US
Practice Address - Phone:440-288-1002
Practice Address - Fax:440-288-1149
Is Sole Proprietor?:No
Enumeration Date:2014-03-04
Last Update Date:2014-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TS0200XBehavioral Health & Social Service ProvidersPsychologistSchool