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General NPI Number Information
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NPI Number | 1720788920
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Entity Type | Individual
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Provider Name | DIAMON CALDWELL
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Gender | Female
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Dates
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Enumeration Date | 03/06/2023
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Last Update Date | 03/06/2023
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Provider Practice Location Address
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Address Line | 3060 KIMBALL BRIDGE RD # 110
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City | ALPHARETTA
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State | GA
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Zip | 30022-1404
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Country | US
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Telephone | 404-388-3909
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Fax |
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Provider Business Mailing Address
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Address Line | 1037 LYNN MARIE WAY
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City | SPARTANBURG
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State | SC
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Zip | 29301-3521
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Country | US
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Telephone | 864-621-6587
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | APC008301
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License Number State | GA
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