Provider Demographics
NPI:1760954820
Name:HIGGINS, JACQUELINE LATULAS (LPC)
Entity Type:Individual
Prefix:MRS
First Name:JACQUELINE
Middle Name:LATULAS
Last Name:HIGGINS
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7718 PEBBLE HILL LN
Mailing Address - Street 2:
Mailing Address - City:ROSHARON
Mailing Address - State:TX
Mailing Address - Zip Code:77583-7275
Mailing Address - Country:US
Mailing Address - Phone:979-292-4082
Mailing Address - Fax:
Practice Address - Street 1:120 E PLUM ST
Practice Address - Street 2:
Practice Address - City:ANGLETON
Practice Address - State:TX
Practice Address - Zip Code:77515-6012
Practice Address - Country:US
Practice Address - Phone:979-549-0889
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-12-28
Last Update Date:2018-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX72768101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional