Individual
MR. DANIEL WYATT HIGGINBOTHAM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
COTA/L
Contact information
Practice address
2 ATHERTON RD, LUTHERVILLE, MD 21093-5701
(567) 712-5933
Mailing address
2 ATHERTON RD, LUTHERVILLE, MD 21093-5701
(567) 712-5933
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
A02282
MD
Other
Enumeration date
10/27/2015
Last updated
10/27/2015
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