Basic Information
Provider Information
NPI: 1811361959
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: DIGGS
FirstName: DANIELLE
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential: B.S.W., MHS
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: PO BOX 29372
Address2:  
City: SHREVEPORT
State: LA
PostalCode: 711499372
CountryCode: US
TelephoneNumber: 3186708898
FaxNumber: 3183003772
Practice Location
Address1: 5902 BUNCOMBE RD
Address2:  
City: SHREVEPORT
State: LA
PostalCode: 711294004
CountryCode: US
TelephoneNumber: 3186708898
FaxNumber: 3183003772
Other Information
ProviderEnumerationDate: 11/29/2015
LastUpdateDate: 11/29/2015
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
104100000X LAY Behavioral Health & Social Service ProvidersSocial Worker 

No ID Information.


Home