Provider Demographics
NPI:1912757469
Name:HIGGINS, COLETTE ERBE (STATE LICENSED ELECT)
Entity Type:Individual
Prefix:
First Name:COLETTE
Middle Name:ERBE
Last Name:HIGGINS
Suffix:
Gender:F
Credentials:STATE LICENSED ELECT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5122 COOPER ROAD
Mailing Address - Street 2:
Mailing Address - City:EDEN
Mailing Address - State:MD
Mailing Address - Zip Code:21822
Mailing Address - Country:US
Mailing Address - Phone:410-334-6222
Mailing Address - Fax:
Practice Address - Street 1:5122 COOPER ROAD
Practice Address - Street 2:
Practice Address - City:EDEN
Practice Address - State:MD
Practice Address - Zip Code:21822
Practice Address - Country:US
Practice Address - Phone:410-334-6222
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-03-26
Last Update Date:2024-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD900046174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist