MEDICARE: HANNA BRIANNE HIGGINS SLPA

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2355S0801X	Speech-Language Assistant	41647	TX

General Provider Information

NPI Number	:	1508468893
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	HANNA BRIANNE HIGGINS SLPA

Provider Business Mailing Address
First Line	:	1030 DALLAS DR APT 414
Second Line	:
City	:	DENTON
State	:	TX
Zip	:	76205-5202
Country	:	US
Telephone Number	:	817-371-6256
Fax Number	:

Provider Business Practice Location Address
First Line	:	1030 DALLAS DR APT 414
Second Line	:
City	:	DENTON
State	:	TX
Zip	:	76205-5202
Country	:	US
Telephone Number	:	817-371-6256
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/11/2020
Last Update Date	:	11/11/2020

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