Provider Demographics
NPI:1710179007
Name:HIGDON, SARAH ANN
Entity Type:Individual
Prefix:
First Name:SARAH
Middle Name:ANN
Last Name:HIGDON
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 1:202 W 7TH ST
Mailing Address - Street 2:
Mailing Address - City:LAMAR
Mailing Address - State:MO
Mailing Address - Zip Code:64759-1285
Mailing Address - Country:US
Mailing Address - Phone:417-682-5571
Mailing Address - Fax:417-682-2411
Practice Address - Street 1:LAMAR R-I
Practice Address - Street 2:202 W 7TH ST
Practice Address - City:LAMAR
Practice Address - State:MO
Practice Address - Zip Code:64759-1285
Practice Address - Country:US
Practice Address - Phone:417-682-5571
Practice Address - Fax:417-682-2411
Is Sole Proprietor?:No
Enumeration Date:2007-08-10
Last Update Date:2009-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2005026866235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO467472700Medicaid