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KRYSTAL HAWKINS RADT1
Addiction (Substance Use Disorder) >> Counselor >> Behavioral Health & Social Service ProvidersRegistrant NPI Number: 1003430398
Individual Registrant: KRYSTAL HAWKINS RADT1
Gender: F
Not Sole Proprietor
Gender: F
Not Sole Proprietor
Location and contact information for practice:
5494 PONY EXSPRESS TRAIL CAMINO, CA 95709 US
Tel: 530-644-3758 Fax: 530-644-3782
Tel: 530-644-3758 Fax: 530-644-3782
Contact information for business:
PO BOX 586 CAMINO, CA 95709-0586 US
Tel: 530-644-3758 Fax: 530-644-3782
Tel: 530-644-3758 Fax: 530-644-3782
Registration Information:
NPI: 1003430398
Entity Type: Individual
Entity Type: Individual
Specialty information:
| Primary | Code | Category/Description | State | License Number |
|---|---|---|---|---|
| N | 101YA0400X | Behavioral Health & Social Service Providers Counselor Addiction (Substance Use Disorder) | ||
| Y | 101YA0400X | Behavioral Health & Social Service Providers Counselor | CA | R1357500819 |
Legacy codes, insurance codes and state license numbers:
| Issuer | Number | State | Type |
|---|---|---|---|
