Provider Demographics
NPI:1396777611
Name:HIGDON, LAURA J (PHD)
Entity type:Individual
Prefix:DR
First Name:LAURA
Middle Name:J
Last Name:HIGDON
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:909 E PALATINE RD
Mailing Address - Street 2:DAVKEN ASSOCIATES, P.C.
Mailing Address - City:PALATINE
Mailing Address - State:IL
Mailing Address - Zip Code:60074-5551
Mailing Address - Country:US
Mailing Address - Phone:847-776-1400
Mailing Address - Fax:847-776-1424
Practice Address - Street 1:909 E PALATINE RD
Practice Address - Street 2:DAVKEN ASSOCIATES, P.C.
Practice Address - City:PALATINE
Practice Address - State:IL
Practice Address - Zip Code:60074-5551
Practice Address - Country:US
Practice Address - Phone:847-776-1400
Practice Address - Fax:847-776-1424
Is Sole Proprietor?:No
Enumeration Date:2006-07-07
Last Update Date:2016-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL071-005935103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
ILK30705Medicare PIN