Healthcare Provider Details

I. General information

NPI: 1700710837
Provider Name (Legal Business Name): TATUM HIGGS OT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/12/2026
Last Update Date: 06/12/2026
Certification Date: 06/12/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2170 COMMERCE DR
BLUFFTON IN
46714-9292
US

IV. Provider business mailing address

2170 COMMERCE DR
BLUFFTON IN
46714-9292
US

V. Phone/Fax

Practice location:
  • Phone: 260-824-0522
  • Fax:
Mailing address:
  • Phone: 260-824-0522
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number31009073A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: