Basic Information
Provider Information
NPI: 1447726971
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: DIGGS
FirstName: DANIELLE
MiddleName: N
NamePrefix:  
NameSuffix:  
Credential:  
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 7000 GOLDEN RING RD UNIT 72126
Address2:  
City: ROSEDALE
State: MD
PostalCode: 212377675
CountryCode: US
TelephoneNumber: 4434180074
FaxNumber:  
Practice Location
Address1: 1900 N HOWARD ST STE 300
Address2:  
City: BALTIMORE
State: MD
PostalCode: 212185909
CountryCode: US
TelephoneNumber: 4434386742
FaxNumber: 4437735624
Other Information
ProviderEnumerationDate: 10/23/2018
LastUpdateDate: 06/21/2022
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: Y
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 06/21/2022

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
101YP2500XLGP7799MDN Behavioral Health & Social Service ProvidersCounselorProfessional
101YM0800XLC11124MDY Behavioral Health & Social Service ProvidersCounselorMental Health

No ID Information.


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