Provider Demographics
NPI:1336965300
Name:HIGGINS, AUSTIN BROOKE (COTA)
Entity type:Individual
Prefix:
First Name:AUSTIN
Middle Name:BROOKE
Last Name:HIGGINS
Suffix:
Gender:F
Credentials:COTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:608 8TH AVE E
Mailing Address - Street 2:
Mailing Address - City:SPRINGFIELD
Mailing Address - State:TN
Mailing Address - Zip Code:37172-2910
Mailing Address - Country:US
Mailing Address - Phone:615-384-8453
Mailing Address - Fax:
Practice Address - Street 1:4120 DUNCAN CHAPEL RD
Practice Address - Street 2:
Practice Address - City:AUBURN
Practice Address - State:KY
Practice Address - Zip Code:42206-9001
Practice Address - Country:US
Practice Address - Phone:270-726-4389
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-11-25
Last Update Date:2024-11-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN4113224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant