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Individual

MRS. GINA HIGGINBOTHAM

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
CCC-SLP

Contact information

Practice address
42 HELTER RD, POCAHONTAS, AR 72455-1359
(870) 248-1448
(870) 248-1450
Mailing address
328 DECLIFF LN, POCAHONTAS, AR 72455-1383
(870) 892-9593
(870) 892-9593

Taxonomy

Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
SP1121
AR

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
129521721
AR
01
5X801
BCBS PROVIDER #
AR
Enumeration date
11/22/2005
Last updated
07/26/2022
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