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Individual

TESS M HIGGINS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
10340 MILTON POTSDAM RD, WEST MILTON, OH 45383-9613
(937) 829-4950
Mailing address
10340 MILTON POTSDAM RD, WEST MILTON, OH 45383-9613
(937) 829-4950

Taxonomy

Speciality
Code
Description
License number
State
347C00000X
Private Vehicle
GSY8351
OH
3747P1801X
Personal Care Attendant
Primary
GSY8351
OH
376J00000X
Homemaker
GSY8351
OH

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0150476
OH
05
121931
OH
Enumeration date
11/18/2020
Last updated
11/18/2020
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