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Individual

VICTORIA HIGGINBOTHAM

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
25 IKEA DR, WESTAMPTON, NJ 08060-5115
(609) 267-9339
Mailing address
25 IKEA DR, WESTAMPTON, NJ 08060-5115

Taxonomy

Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
210634494
NJ
Enumeration date
06/04/2015
Last updated
06/04/2015
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