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

Code values:
01, Other | 02, Medicare Upin | 04, Medicare Id-Type Unspecified
05, Medicaid | 06, Medicare Oscar/Certification | 07, Medicare NSC | 08, Medicare Pin

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