Basic Information
| Provider Information | |||||||||
| NPI: | 1467091264 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | HAWKINS | ||||||||
| FirstName: | BRIANNA | ||||||||
| MiddleName: | LASHAY | ||||||||
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| Mailing Information | |||||||||
| Address1: | 7211 MICKENS RD | ||||||||
| Address2: | |||||||||
| City: | BATON ROUGE | ||||||||
| State: | LA | ||||||||
| PostalCode: | 708115944 | ||||||||
| CountryCode: | US | ||||||||
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| Practice Location | |||||||||
| Address1: | 6685 SULLIVAN RD STE B | ||||||||
| Address2: | |||||||||
| City: | GREENWELL SPRINGS | ||||||||
| State: | LA | ||||||||
| PostalCode: | 707393112 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2252610160 | ||||||||
| FaxNumber: | 2252081181 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 12/27/2019 | ||||||||
| LastUpdateDate: | 12/27/2019 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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| NPICertificationDate: | 12/27/2019 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 101YM0800X | Y | Behavioral Health & Social Service Providers | Counselor | Mental Health |
No ID Information.