Individual
LISA HIGGINS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
515 DENMARK ST, STATESBORO, GA 30458-5287
(843) 949-7085
Mailing address
101 BLUE MOON XING STE 3, POOLER, GA 31322-9798
(843) 949-7085
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
510356
—
101YM0800X
Mental Health Counselor
Primary
007923
GA
101YP2500X
Professional Counselor
007923
GA
171400000X
Health & Wellness Coach
—
—
Other
Enumeration date
05/09/2022
Last updated
12/09/2022
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