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Individual

MISS SOMER NICOLE HIGDON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
DPT, MOT

Contact information

Practice address
695 S NARDO AVE, G4, SOLANA BEACH, CA 92075-2327
(970) 481-7377
Mailing address
695 S NARDO AVE, SOLANA BEACH, CA 92075-2327
(970) 481-7377

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
9257
CO
2251G0304X
Geriatric Physical Therapist
9257
CO
2251S0007X
Sports Physical Therapist
9257
CO
2251X0800X
Orthopedic Physical Therapist
Primary
9257
CO
225X00000X
Occupational Therapist
1074264
CO

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1074264
OT CERTIFICATION
CO
01
9257
PT LICENSE
CO
Enumeration date
10/26/2006
Last updated
11/27/2012
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