Provider Demographics
NPI:1952580243
Name:HIGGINS, TARA MARIE (MS)
Entity type:Individual
Prefix:
First Name:TARA
Middle Name:MARIE
Last Name:HIGGINS
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:375 MISSOURI LN
Mailing Address - Street 2:
Mailing Address - City:KULPMONT
Mailing Address - State:PA
Mailing Address - Zip Code:17834-2011
Mailing Address - Country:US
Mailing Address - Phone:610-737-6524
Mailing Address - Fax:
Practice Address - Street 1:375 MISSOURI LN
Practice Address - Street 2:
Practice Address - City:KULPMONT
Practice Address - State:PA
Practice Address - Zip Code:17834-2011
Practice Address - Country:US
Practice Address - Phone:610-737-6524
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-11-02
Last Update Date:2016-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics