Provider Demographics
NPI:1033245600
Name:HIGGINS, JAYME RENEE' (ATC)
Entity Type:Individual
Prefix:MRS
First Name:JAYME
Middle Name:RENEE'
Last Name:HIGGINS
Suffix:
Gender:F
Credentials:ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1309 VININGS TRL SE # 1309
Mailing Address - Street 2:
Mailing Address - City:SMYRNA
Mailing Address - State:GA
Mailing Address - Zip Code:30080-8641
Mailing Address - Country:US
Mailing Address - Phone:770-436-1152
Mailing Address - Fax:
Practice Address - Street 1:1309 VININGS TRL SE
Practice Address - Street 2:
Practice Address - City:SMYRNA
Practice Address - State:GA
Practice Address - Zip Code:30080-8641
Practice Address - Country:US
Practice Address - Phone:770-436-1152
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAAT0011772255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer