Provider Demographics
NPI:1790904183
Name:HIGBEE, TERRY ANNE (OTRL)
Entity Type:Individual
Prefix:
First Name:TERRY
Middle Name:ANNE
Last Name:HIGBEE
Suffix:
Gender:F
Credentials:OTRL
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:276 E TREMAINE DR
Mailing Address - Street 2:
Mailing Address - City:CHANDLER
Mailing Address - State:AZ
Mailing Address - Zip Code:85225-1006
Mailing Address - Country:US
Mailing Address - Phone:480-892-7311
Mailing Address - Fax:
Practice Address - Street 1:1505 N ALMA SCHOOL RD
Practice Address - Street 2:STE 2
Practice Address - City:CHANDLER
Practice Address - State:AZ
Practice Address - Zip Code:85224-2900
Practice Address - Country:US
Practice Address - Phone:480-626-4142
Practice Address - Fax:480-626-7370
Is Sole Proprietor?:No
Enumeration Date:2007-04-24
Last Update Date:2010-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ0175225XP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ770207Medicaid