Provider Demographics
NPI:1407535446
Name:HUGGINS, ADRIENNE DENISE (CBHCMS)
Entity Type:Individual
Prefix:MRS
First Name:ADRIENNE
Middle Name:DENISE
Last Name:HUGGINS
Suffix:
Gender:F
Credentials:CBHCMS
Other - Prefix:MISS
Other - First Name:ADRIENNE
Other - Middle Name:DENISE
Other - Last Name:MOSES
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1100 SW SAINT LUCIE WEST BLVD STE 105
Mailing Address - Street 2:
Mailing Address - City:PORT SAINT LUCIE
Mailing Address - State:FL
Mailing Address - Zip Code:34986-1779
Mailing Address - Country:US
Mailing Address - Phone:386-283-7123
Mailing Address - Fax:
Practice Address - Street 1:1100 SW SAINT LUCIE WEST BLVD STE 105
Practice Address - Street 2:
Practice Address - City:PORT SAINT LUCIE
Practice Address - State:FL
Practice Address - Zip Code:34986-1779
Practice Address - Country:US
Practice Address - Phone:386-283-7123
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-07-17
Last Update Date:2023-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCWLC.0104337-P405300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes405300000XOther Service ProvidersPrevention Professional