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Individual

HEIDI MARIE HIGGENBOTTOM

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MS,OTR

Contact information

Practice address
1120 S CALUMET RD, SUITE 3, CHESTERTON, IN 46304-3285
(219) 983-9675
Mailing address
442 MANOR DR, HOBART, IN 46342-2376
(219) 730-0331

Taxonomy

Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
225XP0200X
Pediatric Occupational Therapist
31005943A
IN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1104200104
IN
Enumeration date
07/20/2015
Last updated
04/26/2018
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