Provider Demographics
NPI:1689605875
Name:HIGGINS, JOLEE KAY (OTR)
Entity Type:Individual
Prefix:
First Name:JOLEE
Middle Name:KAY
Last Name:HIGGINS
Suffix:
Gender:F
Credentials:OTR
Other - Prefix:
Other - First Name:JOLEE
Other - Middle Name:
Other - Last Name:THOEMKE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1555 NORTHWAY DR
Mailing Address - Street 2:
Mailing Address - City:SAINT CLOUD
Mailing Address - State:MN
Mailing Address - Zip Code:56303-4555
Mailing Address - Country:US
Mailing Address - Phone:320-259-4100
Mailing Address - Fax:320-259-8044
Practice Address - Street 1:1555 NORTHWAY DR
Practice Address - Street 2:
Practice Address - City:SAINT CLOUD
Practice Address - State:MN
Practice Address - Zip Code:56303-4555
Practice Address - Country:US
Practice Address - Phone:320-259-4100
Practice Address - Fax:320-259-8044
Is Sole Proprietor?:No
Enumeration Date:2006-07-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN100370225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist