Provider Demographics
NPI:1689213225
Name:HIGGINS, BRIANNA (ALC, MA)
Entity Type:Individual
Prefix:
First Name:BRIANNA
Middle Name:
Last Name:HIGGINS
Suffix:
Gender:F
Credentials:ALC, MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16167 PARKE BLVD N
Mailing Address - Street 2:
Mailing Address - City:FOLEY
Mailing Address - State:AL
Mailing Address - Zip Code:36535-8597
Mailing Address - Country:US
Mailing Address - Phone:940-704-7412
Mailing Address - Fax:
Practice Address - Street 1:1120 HILLCREST RD STE 2G
Practice Address - Street 2:
Practice Address - City:MOBILE
Practice Address - State:AL
Practice Address - Zip Code:36695-3955
Practice Address - Country:US
Practice Address - Phone:940-704-7412
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-12-30
Last Update Date:2019-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ALC3461A101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor