Provider Demographics
NPI:1679253439
Name:HIGGINS, KRISTEN M (MAT)
Entity type:Individual
Prefix:
First Name:KRISTEN
Middle Name:M
Last Name:HIGGINS
Suffix:
Gender:F
Credentials:MAT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8003 MAPLE AVE APT 2
Mailing Address - Street 2:
Mailing Address - City:TAKOMA PARK
Mailing Address - State:MD
Mailing Address - Zip Code:20912-6335
Mailing Address - Country:US
Mailing Address - Phone:508-857-6016
Mailing Address - Fax:
Practice Address - Street 1:8003 MAPLE AVE APT 2
Practice Address - Street 2:
Practice Address - City:TAKOMA PARK
Practice Address - State:MD
Practice Address - Zip Code:20912-6335
Practice Address - Country:US
Practice Address - Phone:508-857-6016
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-07-18
Last Update Date:2023-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251C00000XAgenciesDay Training, Developmentally Disabled Services
No253Z00000XAgenciesIn Home Supportive Care