Healthcare Provider Details

I. General information

NPI: 1437963006
Provider Name (Legal Business Name): MALORIE LYNN HIGGINS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/04/2025
Last Update Date: 05/15/2026
Certification Date: 05/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8001 BEATY GROVE DR
TAMPA FL
33626-1602
US

IV. Provider business mailing address

8774 N PELICAN TER
CITRUS SPRINGS FL
34434-5415
US

V. Phone/Fax

Practice location:
  • Phone: 813-926-5454
  • Fax:
Mailing address:
  • Phone: 219-929-7675
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106E00000X
TaxonomyAssistant Behavior Analyst
License Number0-26-17152
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: