Provider Demographics
NPI:1225289515
Name:HIGGINS, KATHLEEN ANN (PT)
Entity Type:Individual
Prefix:MS
First Name:KATHLEEN
Middle Name:ANN
Last Name:HIGGINS
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:41 ANGELINA LN
Mailing Address - Street 2:
Mailing Address - City:MANSFIELD
Mailing Address - State:MA
Mailing Address - Zip Code:02048-2845
Mailing Address - Country:US
Mailing Address - Phone:508-339-4857
Mailing Address - Fax:
Practice Address - Street 1:500 CHAPMAN ST
Practice Address - Street 2:SUITE 104
Practice Address - City:CANTON
Practice Address - State:MA
Practice Address - Zip Code:02021-2093
Practice Address - Country:US
Practice Address - Phone:508-821-9955
Practice Address - Fax:508-821-9950
Is Sole Proprietor?:Yes
Enumeration Date:2008-10-05
Last Update Date:2008-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA31842251P0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251P0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistPediatrics