Healthcare Provider Details

I. General information

NPI: 1710442256
Provider Name (Legal Business Name): NANCY HIGGINS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/08/2019
Last Update Date: 06/20/2026
Certification Date: 06/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

15617 88TH PL N
LOXAHATCHEE FL
33470-2877
US

IV. Provider business mailing address

15617 88TH PL N
LOXAHATCHEE FL
33470-2877
US

V. Phone/Fax

Practice location:
  • Phone: 313-515-5530
  • Fax:
Mailing address:
  • Phone: 313-515-5530
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number27749
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: