Provider Demographics
NPI:1649804857
Name:HIGGS, LYDIA KATHERINE (MS, LCGC)
Entity type:Individual
Prefix:MS
First Name:LYDIA
Middle Name:KATHERINE
Last Name:HIGGS
Suffix:
Gender:F
Credentials:MS, LCGC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1211 S JEFFERSON ST
Mailing Address - Street 2:
Mailing Address - City:ROANOKE
Mailing Address - State:VA
Mailing Address - Zip Code:24016-4705
Mailing Address - Country:US
Mailing Address - Phone:540-985-9889
Mailing Address - Fax:540-857-9130
Practice Address - Street 1:1211 S JEFFERSON ST
Practice Address - Street 2:
Practice Address - City:ROANOKE
Practice Address - State:VA
Practice Address - Zip Code:24016-4705
Practice Address - Country:US
Practice Address - Phone:540-985-9889
Practice Address - Fax:540-857-9130
Is Sole Proprietor?:No
Enumeration Date:2020-02-26
Last Update Date:2020-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0139000003170300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes170300000XOther Service ProvidersGenetic Counselor, MS