DR. MARTHA NAN HAWKES PHD
Clinical Neuropsychologist
Germantown, Tennessee
Provider NPI: 1184615601
Provider Information:DR. MARTHA NAN HAWKES PHD
Gender: F
Sole Proprietor
Practice Location:
7655 POPLAR AVE #365 GERMANTOWN, TN 38138 US
Tel: 901-751-3571 Fax: 901-751-3572
Business Mailing Address:
7655 POPLAR AVE #365 GERMANTOWN, TN 38138 US
Tel: 901-751-3571 Fax: 901-751-3572
Entity Type: Individual
Taxonomy:
Primary | Code | Category/Description | State | License Number |
---|---|---|---|---|
Y | 103G00000X | Behavioral Health & Social Service Providers Clinical Neuropsychologist | TN | P0000001132 |
N | 103T00000X | Behavioral Health & Social Service Providers Psychologist | TN | P0000001132 |
Other Provider Identifiers:
Issuer | Number | State | Type |
---|---|---|---|
3685330 | TN | 05 |
01, Other | 02, Medicare Upin | 04, Medicare Id-Type Unspecified
05, Medicaid | 06, Medicare Oscar/Certification | 07, Medicare NSC | 08, Medicare Pin