Provider Demographics
NPI:1770289670
Name:HAWKINS, DANIELLE VICTORIA DESIMONE
Entity type:Individual
Prefix:
First Name:DANIELLE
Middle Name:VICTORIA DESIMONE
Last Name:HAWKINS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:323 TERRACE POINT CIR
Mailing Address - Street 2:
Mailing Address - City:MUSKEGON
Mailing Address - State:MI
Mailing Address - Zip Code:49440-1304
Mailing Address - Country:US
Mailing Address - Phone:810-429-0644
Mailing Address - Fax:
Practice Address - Street 1:3611 HENRY ST
Practice Address - Street 2:
Practice Address - City:NORTON SHORES
Practice Address - State:MI
Practice Address - Zip Code:49441-4705
Practice Address - Country:US
Practice Address - Phone:231-237-8898
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-02-01
Last Update Date:2023-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6362009677103TC1900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounseling