Provider Demographics
NPI:1225699366
Name:HIGGINS, LILLI KAY (CTRS/L)
Entity Type:Individual
Prefix:
First Name:LILLI
Middle Name:KAY
Last Name:HIGGINS
Suffix:
Gender:F
Credentials:CTRS/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3913 E 32ND PL
Mailing Address - Street 2:
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74135-1638
Mailing Address - Country:US
Mailing Address - Phone:918-232-9402
Mailing Address - Fax:
Practice Address - Street 1:1801 N HIGHWAY 66
Practice Address - Street 2:
Practice Address - City:CATOOSA
Practice Address - State:OK
Practice Address - Zip Code:74015-3067
Practice Address - Country:US
Practice Address - Phone:918-346-7756
Practice Address - Fax:539-444-7059
Is Sole Proprietor?:Yes
Enumeration Date:2019-06-27
Last Update Date:2021-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK190225800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225800000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRecreation TherapistGroup - Single Specialty