Individual
MRS. AMANDA MARIE HIGGINBOTHAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MA, LPC
Contact information
Practice address
1 WESTMINSTER PL STE 101, LAKE FOREST, IL 60045-5511
(847) 919-9096
Mailing address
610 SMITH AVE, LAKE BLUFF, IL 60044-1719
(224) 203-6156
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
178.015011
IL
Other
Enumeration date
06/26/2023
Last updated
06/26/2023
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