Organization
HIGGINBOTHAM THERAPY PROVIDERS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GINA L HIGGINBOTHAM CCC-SLP (PRESIDENT)
(870) 892-9593
Entity
Organization
Contact information
Practice address
42 HELTER RD, POCAHONTAS, AR 72455
(870) 248-1448
(870) 248-1450
Mailing address
328 DECLIFF LN, POCAHONTAS, AR 72455-1383
(870) 892-9593
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
1121
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
185600742
—
AR
Enumeration date
01/25/2011
Last updated
07/26/2022
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