Provider Demographics
NPI:1063782910
Name:HIGGINS, KATRINA ALBERTA
Entity type:Individual
Prefix:
First Name:KATRINA
Middle Name:ALBERTA
Last Name:HIGGINS
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 1:705 BEN WILLIAMS RD
Mailing Address - Street 2:LOT 8
Mailing Address - City:JACKSONVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28540-8806
Mailing Address - Country:US
Mailing Address - Phone:910-750-0497
Mailing Address - Fax:
Practice Address - Street 1:705 BEN WILLIAMS RD
Practice Address - Street 2:LOT 8
Practice Address - City:JACKSONVILLE
Practice Address - State:NC
Practice Address - Zip Code:28540-8806
Practice Address - Country:US
Practice Address - Phone:910-750-0497
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-01-10
Last Update Date:2012-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst