Provider Demographics
NPI:1699224162
Name:HIGDON, ANNETTE (BSW, MA, S/T)
Entity Type:Individual
Prefix:
First Name:ANNETTE
Middle Name:
Last Name:HIGDON
Suffix:
Gender:F
Credentials:BSW, MA, S/T
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1400 CLAY AVE SW
Mailing Address - Street 2:
Mailing Address - City:CAIRO
Mailing Address - State:GA
Mailing Address - Zip Code:39828-2853
Mailing Address - Country:US
Mailing Address - Phone:229-221-1212
Mailing Address - Fax:
Practice Address - Street 1:1400 CLAY AVE SW
Practice Address - Street 2:
Practice Address - City:CAIRO
Practice Address - State:GA
Practice Address - Zip Code:39828-2853
Practice Address - Country:US
Practice Address - Phone:229-221-1212
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-09-26
Last Update Date:2016-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP1600XBehavioral Health & Social Service ProvidersCounselorPastoral