Basic Information
| Provider Information | |||||||||
| NPI: | 1689981268 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | KEDDIE- HIGGINS | ||||||||
| FirstName: | ALLISON | ||||||||
| MiddleName: | J | ||||||||
| NamePrefix: | |||||||||
| NameSuffix: | |||||||||
| Credential: | LMHC | ||||||||
| OtherOrganizationName: | |||||||||
| OtherOrganizationType: | |||||||||
| OtherLastName: | KEDDIE | ||||||||
| OtherFirstName: | ALLISON | ||||||||
| OtherMiddleName: | |||||||||
| OtherNamePrefix: | |||||||||
| OtherNameSuffix: | |||||||||
| OtherCredential: | LMHC | ||||||||
| OtherLastNameType: | 2 | ||||||||
| Mailing Information | |||||||||
| Address1: | 3176 ABBOTT RD | ||||||||
| Address2: | BUILDING A, SUITE 500 | ||||||||
| City: | ORCHARD PARK | ||||||||
| State: | NY | ||||||||
| PostalCode: | 141271069 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7168222117 | ||||||||
| FaxNumber: | 7168228165 | ||||||||
| Practice Location | |||||||||
| Address1: | 3176 ABBOTT RD | ||||||||
| Address2: | BUILDING A, SUITE 500 | ||||||||
| City: | ORCHARD PARK | ||||||||
| State: | NY | ||||||||
| PostalCode: | 141271069 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7168222117 | ||||||||
| FaxNumber: | 7168228165 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 09/03/2010 | ||||||||
| LastUpdateDate: | 11/20/2013 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| AuthorizedOfficialMiddleName: | |||||||||
| AuthorizedOfficialTitleorPosition: | |||||||||
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| IsSoleProprietor: | Y | ||||||||
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| NPICertificationDate: | |||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 101YM0800X | N | Behavioral Health & Social Service Providers | Counselor | Mental Health | 101YM0800X | 005555 | NY | Y | Behavioral Health & Social Service Providers | Counselor | Mental Health |
No ID Information.