Provider Demographics
NPI:1083325427
Name:HIGGS, HOLLY MARIE (PSYD)
Entity type:Individual
Prefix:DR
First Name:HOLLY
Middle Name:MARIE
Last Name:HIGGS
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2027 RANDALL ST
Mailing Address - Street 2:
Mailing Address - City:LORAIN
Mailing Address - State:OH
Mailing Address - Zip Code:44052-3255
Mailing Address - Country:US
Mailing Address - Phone:440-541-3339
Mailing Address - Fax:
Practice Address - Street 1:25111 COUNTRY CLUB BLVD
Practice Address - Street 2:
Practice Address - City:NORTH OLMSTED
Practice Address - State:OH
Practice Address - Zip Code:44070-5345
Practice Address - Country:US
Practice Address - Phone:216-468-5000
Practice Address - Fax:440-614-2526
Is Sole Proprietor?:No
Enumeration Date:2022-12-07
Last Update Date:2022-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHP.6942103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist