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KRYSTAL HAWKINS RADT1

Addiction (Substance Use Disorder) >> Counselor >> Behavioral Health & Social Service Providers

Registrant NPI Number: 1003430398

Individual Registrant:
 KRYSTAL  HAWKINS RADT1
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

Contact information for business:
PO BOX 586  CAMINO, CA 95709-0586 US
Tel: 530-644-3758  Fax: 530-644-3782

Registration Information:
NPI: 1003430398
Entity Type: Individual

Specialty information:

PrimaryCodeCategory/DescriptionStateLicense Number
N101YA0400XBehavioral Health & Social Service Providers
Counselor
Addiction (Substance Use Disorder)
Y101YA0400XBehavioral Health & Social Service Providers
Counselor
CAR1357500819

Legacy codes, insurance codes and state license numbers:

IssuerNumberStateType




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