Most Relevant Information
Provider Data
| NPI Number: | 1003062688 |
| Provider Name: | LARRY HIGGINBOTTOM MSW / LCSW |
| Entity Type: | Individual |
| Taxonomy Code: | 1041C0700X |
| Specialty: | Social Worker |
| License Number: | 2030131 |
Most Important Dates
| Enumeration Date: | 08/14/2008 |
| Last Updated: | 08/14/2008 |
Provider Practice Location
184 DUDLEY ST
SUITE 107 LL
ROXBURY
MA
021192561
Practice Location Phone/Fax
| Phone: | 6174422002 |
| Fax: | 6174424002 |
Provider Mailing Location
184 DUDLEY ST
SUITE 107 LL
ROXBURY
MA
021192561
Provider Mailing Phone/Fax
| Phone: | 6174422002 |
| Fax: | 6174424002 |