Healthcare Provider Details

I. General information

NPI: 1447726971
Provider Name (Legal Business Name): DANIELLE N DIGGS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/23/2018
Last Update Date: 06/21/2022
Certification Date: 06/21/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1900 N HOWARD ST STE 300
BALTIMORE MD
21218-5909
US

IV. Provider business mailing address

7000 GOLDEN RING RD UNIT 72126
ROSEDALE MD
21237-7675
US

V. Phone/Fax

Practice location:
  • Phone: 443-438-6742
  • Fax: 443-773-5624
Mailing address:
  • Phone: 443-418-0074
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberLGP7799
License Number StateMD
# 2
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberLC11124
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: