Doctor Name: | RONALD HIGGINBOTHAM |
NPI Number: | 1154726792 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | SLP-A |
License Number: | SLPA7896 |
Business Practice Address: | 433 N Sibyl Rd Saint David, AZ - 856306115 |
Business Phone Number: | 5207209790 |
Business Fax Number: | |
Mailing Address: | 433 N Sibyl Rd, SAINT DAVID |
State: | AZ |
Postal Code: | 856306115 |
Phone Number: | 5207209790 |
Fax Number: | |
NPI Enumeration Date: | 10/24/2014 |
NPI Last Update Date: | 10/24/2014 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 2355S0801X |
License Number: | SLPA7896 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | AZ |
Taxonomy Type: | Speech, Language and Hearing Service Providers |
Taxonomy Classification: | Specialist/Technologist |
Taxonomy Specialization: | Speech-Language Assistant |
Taxonomy Definition: |