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General NPI Number Information
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NPI Number | 1295036853
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Entity Type | Individual
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Provider Name | MS. IKESHIA S. L. HIGHSMITH
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Gender | Female
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Dates
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Enumeration Date | 11/12/2010
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Last Update Date | 11/12/2010
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Provider Practice Location Address
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Address Line | 2634 CAPITAL CIR NE
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City | TALLAHASSEE
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State | FL
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Zip | 32308-4106
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Country | US
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Telephone | 850-523-3218
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Fax |
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Provider Business Mailing Address
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Address Line | 2614 OLD BAINBRIDGE RD APT. D
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City | TALLAHASSEE
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State | FL
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Zip | 32303-9213
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Country | US
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Telephone | 813-407-9380
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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 | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State |
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