Provider Demographics
NPI:1144496738
Name:HIGGINS, JANET MARIE
Entity type:Individual
Prefix:
First Name:JANET
Middle Name:MARIE
Last Name:HIGGINS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13570 W PLEASANTVIEW CT
Mailing Address - Street 2:
Mailing Address - City:NEW BERLIN
Mailing Address - State:WI
Mailing Address - Zip Code:53151-5385
Mailing Address - Country:US
Mailing Address - Phone:262-786-5773
Mailing Address - Fax:
Practice Address - Street 1:13570 W PLEASANTVIEW CT
Practice Address - Street 2:
Practice Address - City:NEW BERLIN
Practice Address - State:WI
Practice Address - Zip Code:53151-5385
Practice Address - Country:US
Practice Address - Phone:262-786-5773
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-05-02
Last Update Date:2008-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI775-154235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI42712300Medicaid