Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 101Y00000X | Counselor | E.8198 | OH |
N | 101YM0800X | Mental Health Counselor | E.8198 | OH |
Y | 101YM0800X | Mental Health Counselor | E0008198 | OH |
N | 101YP1600X | Pastoral Counselor | E.8198 | OH |
N | 101YP2500X | Professional Counselor | E.8198 | OH |
NPI | 1083036545 |
---|---|
Provider Name | Roger Higginbotham |
First Address | Mansfield, OH 44903-2223 |
Second Address | Mansfield, OH 44903-2223 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 16/01/2014 |
Last Update Date | 25/09/2014 |