Provider Demographics
NPI:1467760983
Name:HIGGINS-DABAT, ANISSA JEAN (MA COUNSLING)
Entity Type:Individual
Prefix:
First Name:ANISSA
Middle Name:JEAN
Last Name:HIGGINS-DABAT
Suffix:
Gender:F
Credentials:MA COUNSLING
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:310 OAKLAWN DR
Mailing Address - Street 2:
Mailing Address - City:WEST MONROE
Mailing Address - State:LA
Mailing Address - Zip Code:71291-2438
Mailing Address - Country:US
Mailing Address - Phone:318-267-2294
Mailing Address - Fax:
Practice Address - Street 1:310 OAKLAWN DR
Practice Address - Street 2:
Practice Address - City:WEST MONROE
Practice Address - State:LA
Practice Address - Zip Code:71291-2438
Practice Address - Country:US
Practice Address - Phone:318-267-2294
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-09-17
Last Update Date:2010-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA3901101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional