Provider Demographics
NPI:1497505044
Name:HUGGINS, RENARDA S (CLINICIAN)
Entity Type:Individual
Prefix:
First Name:RENARDA
Middle Name:S
Last Name:HUGGINS
Suffix:
Gender:F
Credentials:CLINICIAN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:21 PINE ST
Mailing Address - Street 2:
Mailing Address - City:CANTON
Mailing Address - State:MA
Mailing Address - Zip Code:02021-3344
Mailing Address - Country:US
Mailing Address - Phone:857-212-6058
Mailing Address - Fax:
Practice Address - Street 1:1351 MAIN ST
Practice Address - Street 2:
Practice Address - City:BROCKTON
Practice Address - State:MA
Practice Address - Zip Code:02301-7153
Practice Address - Country:US
Practice Address - Phone:508-857-0239
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-03-26
Last Update Date:2024-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)