Provider Demographics
NPI:1902127202
Name:HIGGINS, TERRI LYNN (MLS, LMT)
Entity Type:Individual
Prefix:MRS
First Name:TERRI
Middle Name:LYNN
Last Name:HIGGINS
Suffix:
Gender:F
Credentials:MLS, LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3135 39TH AVE N
Mailing Address - Street 2:SUITE 9
Mailing Address - City:SAINT PETERSBURG
Mailing Address - State:FL
Mailing Address - Zip Code:33714-4500
Mailing Address - Country:US
Mailing Address - Phone:727-455-7632
Mailing Address - Fax:
Practice Address - Street 1:3135 39TH AVE N
Practice Address - Street 2:SUITE 9
Practice Address - City:SAINT PETERSBURG
Practice Address - State:FL
Practice Address - Zip Code:33714-4500
Practice Address - Country:US
Practice Address - Phone:727-455-7632
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-06-21
Last Update Date:2010-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMA#58258225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist