Provider Demographics
NPI:1578807848
Name:HIGGINSBEE, MARLA PUAALA
Entity Type:Individual
Prefix:MRS
First Name:MARLA
Middle Name:PUAALA
Last Name:HIGGINSBEE
Suffix:
Gender:F
Credentials:
Other - Prefix:MRS
Other - First Name:MARLA
Other - Middle Name:PUAALA
Other - Last Name:HIGGINS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:COTA
Mailing Address - Street 1:45-141 MOKULELE DR
Mailing Address - Street 2:A
Mailing Address - City:KANEOHE
Mailing Address - State:HI
Mailing Address - Zip Code:96744-2337
Mailing Address - Country:US
Mailing Address - Phone:808-225-4927
Mailing Address - Fax:
Practice Address - Street 1:45-141 MOKULELE DR
Practice Address - Street 2:A
Practice Address - City:KANEOHE
Practice Address - State:HI
Practice Address - Zip Code:96744-2337
Practice Address - Country:US
Practice Address - Phone:808-225-4927
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-11-26
Last Update Date:2012-11-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HI983572224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
HI224Z00000XMedicaid