Provider Demographics
NPI:1558669580
Name:HIGGS, STEFANY
Entity Type:Individual
Prefix:
First Name:STEFANY
Middle Name:
Last Name:HIGGS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1600 N D ST
Mailing Address - Street 2:
Mailing Address - City:MCALESTER
Mailing Address - State:OK
Mailing Address - Zip Code:74501-2314
Mailing Address - Country:US
Mailing Address - Phone:918-423-2559
Mailing Address - Fax:
Practice Address - Street 1:1600 N D ST
Practice Address - Street 2:
Practice Address - City:MCALESTER
Practice Address - State:OK
Practice Address - Zip Code:74501-2314
Practice Address - Country:US
Practice Address - Phone:918-423-2559
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-02-28
Last Update Date:2011-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health