Provider Demographics
NPI:1891484515
Name:HIGGINS, WILLOW DAWN (PT, DPT)
Entity Type:Individual
Prefix:
First Name:WILLOW
Middle Name:DAWN
Last Name:HIGGINS
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8199 NAVARRE PKWY STE 12A
Mailing Address - Street 2:
Mailing Address - City:NAVARRE
Mailing Address - State:FL
Mailing Address - Zip Code:32566-6941
Mailing Address - Country:US
Mailing Address - Phone:850-939-1233
Mailing Address - Fax:850-939-5097
Practice Address - Street 1:8199 NAVARRE PKWY STE 12A
Practice Address - Street 2:
Practice Address - City:NAVARRE
Practice Address - State:FL
Practice Address - Zip Code:32566-6941
Practice Address - Country:US
Practice Address - Phone:850-939-1233
Practice Address - Fax:850-939-5097
Is Sole Proprietor?:No
Enumeration Date:2023-05-08
Last Update Date:2023-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPT39431225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist