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General NPI Number Information
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NPI Number | 1760954820
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Entity Type | Individual
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Provider Name | JACQUELINE LATULAS HIGGINS LPC
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Gender | Female
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Dates
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Enumeration Date | 12/28/2018
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Last Update Date | 12/28/2018
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Provider Practice Location Address
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Address Line | 120 E PLUM ST
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City | ANGLETON
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State | TX
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Zip | 77515-6012
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Country | US
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Telephone | 979-549-0889
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Fax |
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Provider Business Mailing Address
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Address Line | 7718 PEBBLE HILL LN
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City | ROSHARON
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State | TX
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Zip | 77583-7275
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Country | US
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Telephone | 979-292-4082
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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 | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 72768
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License Number State | TX
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