Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 102L00000X | Psychologist | PY00002717 | WA |
Y | 103T00000X | Psychologist | PY00002717 | WA |
N | 103G00000X | Clinical Psychologist | PY00002717 | WA |
N | 103TC0700X | Clinical Psychologist | PY00002717 | WA |
N | 103TC1900X | Counseling Psychologist | PY00002717 | WA |
N | 103TC2200X | Clinical Child & Adolescent Psychologist | PY00002717 | WA |
NPI | 1013211648 |
---|---|
Provider Name | Dr. Susan A Hawkins |
First Address | Seattle, WA 98112-4214 |
Second Address | Seattle, WA 98112-4214 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 21/12/2010 |
Last Update Date | 21/12/2010 |