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1366945388
TARA HIGGINBOTHAM
MANDEVILLE, LA
NPI
1366945388
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
363LP0808X Nurse Practitioner, Psych/Mental Health
(Licence: LA 227420)
Enumeration Date
2018-03-15
Last Update Date
2023-01-25
Business Address
TARA HIGGINBOTHAM PMHNP
23699 QUAIL LANE
MANDEVILLE, LA 70448
Phone number: 985-334-4040
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Mailing Address
TARA HIGGINBOTHAM PMHNP
23699 QUAIL LANE
MANDEVILLE, LA 70448
Phone number: 985-334-4040
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