Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 101YA0400X | Addiction Counselor (Substance Use Disorder) | LCO869 | MD |
N | 101YM0800X | Mental Health Counselor | MD | |
N | 101YM0800X | Mental Health Counselor | LCO869 | MD |
Y | 101YP2500X | Professional Counselor | LCO869 | MD |
N | 101YS0200X | School Counselor | LCO869 | MD |
NPI | 1174761639 |
---|---|
Provider Name | Dr. Vanessa Hawkes |
First Address | Windsor Mill, MD 21244-1163 |
Second Address | Baltimore, MD 21230-2324 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 21/01/2009 |
Last Update Date | 09/04/2010 |