Provider Demographics
NPI:1730997156
Name:HIGGINS, CATHY JO
Entity type:Individual
Prefix:
First Name:CATHY JO
Middle Name:
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 1:12 KILLEN HOLLOW DR
Mailing Address - Street 2:
Mailing Address - City:CROSS LANES
Mailing Address - State:WV
Mailing Address - Zip Code:25313-3516
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:681-217-1593
Practice Address - Street 1:12 KILLEN HOLLOW DR
Practice Address - Street 2:
Practice Address - City:CROSS LANES
Practice Address - State:WV
Practice Address - Zip Code:25313-3516
Practice Address - Country:US
Practice Address - Phone:304-881-2585
Practice Address - Fax:681-217-1593
Is Sole Proprietor?:Yes
Enumeration Date:2024-12-19
Last Update Date:2025-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Multi-Specialty
No252Y00000XAgenciesEarly Intervention Provider Agency