Provider Demographics
NPI:1518388552
Name:HIGGINS, JENNIFER (MED)
Entity Type:Individual
Prefix:MRS
First Name:JENNIFER
Middle Name:
Last Name:HIGGINS
Suffix:
Gender:F
Credentials:MED
Other - Prefix:
Other - First Name:JENNIFER
Other - Middle Name:
Other - Last Name:HIGGINS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MED
Mailing Address - Street 1:1200 1ST ST NE
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20002-3361
Mailing Address - Country:US
Mailing Address - Phone:202-282-0120
Mailing Address - Fax:
Practice Address - Street 1:1200 1ST ST NE
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20002-3361
Practice Address - Country:US
Practice Address - Phone:202-282-0120
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-12-18
Last Update Date:2013-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DC103TS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TS0200XBehavioral Health & Social Service ProvidersPsychologistSchool