Provider Demographics
NPI:1972340354
Name:BIGGS, KAMIRA ALISE
Entity type:Individual
Prefix:
First Name:KAMIRA
Middle Name:ALISE
Last Name:BIGGS
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 1:3920 BROWNELL BLVD
Mailing Address - Street 2:
Mailing Address - City:FLINT
Mailing Address - State:MI
Mailing Address - Zip Code:48504-3713
Mailing Address - Country:US
Mailing Address - Phone:901-832-7788
Mailing Address - Fax:
Practice Address - Street 1:3290 W BIG BEAVER RD
Practice Address - Street 2:
Practice Address - City:TROY
Practice Address - State:MI
Practice Address - Zip Code:48084-2903
Practice Address - Country:US
Practice Address - Phone:989-513-0782
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-07-11
Last Update Date:2024-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician