Provider Demographics
NPI:1740225895
Name:HIGDON, CHRISTIE LYNN (OT)
Entity Type:Individual
Prefix:MS
First Name:CHRISTIE
Middle Name:LYNN
Last Name:HIGDON
Suffix:
Gender:F
Credentials:OT
Other - Prefix:
Other - First Name:CHRISTIE
Other - Middle Name:
Other - Last Name:TIMBERLAKE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 911148
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON
Mailing Address - State:KY
Mailing Address - Zip Code:40591-1148
Mailing Address - Country:US
Mailing Address - Phone:859-278-2121
Mailing Address - Fax:859-276-2795
Practice Address - Street 1:467 EASTERN BY-PASS
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:KY
Practice Address - Zip Code:40475
Practice Address - Country:US
Practice Address - Phone:859-623-6334
Practice Address - Fax:859-623-6336
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-06-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KYR2656225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY8800055900Medicaid