Provider Demographics
NPI:1265142541
Name:HIGGS, CHARNELE
Entity type:Individual
Prefix:
First Name:CHARNELE
Middle Name:
Last Name:HIGGS
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 1:357 FAUCETTE AVE
Mailing Address - Street 2:
Mailing Address - City:BURLINGTON
Mailing Address - State:NC
Mailing Address - Zip Code:27215-1989
Mailing Address - Country:US
Mailing Address - Phone:336-512-6842
Mailing Address - Fax:
Practice Address - Street 1:357 FAUCETTE AVE
Practice Address - Street 2:
Practice Address - City:BURLINGTON
Practice Address - State:NC
Practice Address - Zip Code:27215-1989
Practice Address - Country:US
Practice Address - Phone:336-512-6842
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-11-28
Last Update Date:2022-11-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician