Healthcare Provider Details

I. General information

NPI: 1144505777
Provider Name (Legal Business Name): KAMIL DENISE TAYLOR-DIGGS LMSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/14/2011
Last Update Date: 05/04/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5255 SNAPFINGER PARK DR STE 120
DECATUR GA
30035-4066
US

IV. Provider business mailing address

182 ODYSSEY TURN
CONYERS GA
30012-3680
US

V. Phone/Fax

Practice location:
  • Phone: 678-389-4856
  • Fax:
Mailing address:
  • Phone: 310-890-1411
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License NumberMSW008816
License Number StateGA
# 2
Primary TaxonomyN
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: