Provider Demographics
NPI:1952742066
Name:HAWKINS, MALI JANE (LMFTA)
Entity Type:Individual
Prefix:MRS
First Name:MALI
Middle Name:JANE
Last Name:HAWKINS
Suffix:
Gender:F
Credentials:LMFTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4714 34TH AVE NE
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98105-4007
Mailing Address - Country:US
Mailing Address - Phone:253-241-9592
Mailing Address - Fax:
Practice Address - Street 1:444 NE RAVENNA BLVD STE 308
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98115-6467
Practice Address - Country:US
Practice Address - Phone:253-241-9592
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-07-17
Last Update Date:2013-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMG60375050106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist