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General NPI Number Information
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NPI Number | 1033486576
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Entity Type | Individual
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Provider Name | SUSAN R HIGLEY L.M.T.
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Gender | Female
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Dates
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Enumeration Date | 11/29/2011
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Last Update Date | 08/04/2014
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Provider Practice Location Address
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Address Line | 7780 49TH ST N # 146
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City | PINELLAS PARK
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State | FL
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Zip | 33781-3440
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Country | US
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Telephone | 727-475-6630
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Fax |
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Provider Business Mailing Address
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Address Line | 6471 64TH AVE N
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City | PINELLAS PARK
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State | FL
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Zip | 33781-5217
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Country | US
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Telephone | 727-459-6630
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 124Q00000X
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Taxonomy Name | Dental Hygienist
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License Number | DH7097
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 225700000X
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Taxonomy Name | Massage Therapist
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License Number | MA41530
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License Number State | FL
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