Provider Demographics
NPI:1538425962
Name:HAWKINS, MARILYN YEVONNE (AS, BS, MA)
Entity type:Individual
Prefix:MS
First Name:MARILYN
Middle Name:YEVONNE
Last Name:HAWKINS
Suffix:
Gender:F
Credentials:AS, BS, MA
Other - Prefix:MS
Other - First Name:MARILYN
Other - Middle Name:YEVONNE
Other - Last Name:KNIGHT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2610 URBAN LEAGUE CT
Mailing Address - Street 2:
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73105-3333
Mailing Address - Country:US
Mailing Address - Phone:405-532-8581
Mailing Address - Fax:
Practice Address - Street 1:4401 NW 4TH ST STE 123
Practice Address - Street 2:
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73107-6540
Practice Address - Country:US
Practice Address - Phone:405-601-1716
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-04-10
Last Update Date:2012-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)