Basic Information
| Provider Information | |||||||||
| NPI: | 1467418301 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | HAWKINS | ||||||||
| FirstName: | REBECCA | ||||||||
| MiddleName: | S | ||||||||
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| Credential: | PH.D | ||||||||
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| Mailing Information | |||||||||
| Address1: | 4770 E ILIFF AVE STE 107 | ||||||||
| Address2: | |||||||||
| City: | DENVER | ||||||||
| State: | CO | ||||||||
| PostalCode: | 802226049 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3038301181 | ||||||||
| FaxNumber: | 3038300270 | ||||||||
| Practice Location | |||||||||
| Address1: | 4770 E ILIFF AVE STE 107 | ||||||||
| Address2: | |||||||||
| City: | DENVER | ||||||||
| State: | CO | ||||||||
| PostalCode: | 802226049 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3038301181 | ||||||||
| FaxNumber: | 3038300270 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 04/20/2006 | ||||||||
| LastUpdateDate: | 11/05/2012 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 103G00000X | 2582 | CO | N | Behavioral Health & Social Service Providers | Clinical Neuropsychologist | 103T00000X | 2582 | CO | N | Behavioral Health & Social Service Providers | Psychologist | 103TC0700X | 2582 | CO | Y | Behavioral Health & Social Service Providers | Psychologist | Clinical |
No ID Information.