Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101YP1600X | Pastoral Counselor |
NPI | 1144671843 |
---|---|
Provider Name | Dr. Thomas Joel Hawkins |
First Address | Lawrenceville, GA 30043-3113 |
Second Address | Lawrenceville, GA 30043-3113 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 24/06/2016 |
Last Update Date | 24/06/2016 |