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General NPI Number Information
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NPI Number | 1871058859
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Entity Type | Individual
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Provider Name | DONNETTE DEIGH
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Gender | Female
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Dates
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Enumeration Date | 02/05/2019
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Last Update Date | 02/05/2019
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Provider Practice Location Address
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Address Line | 583 FREDERICK RD STE 6B
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City | CATONSVILLE
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State | MD
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Zip | 21228-4697
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Country | US
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Telephone | 410-870-5615
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Fax |
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Provider Business Mailing Address
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Address Line | 6915 BONNIE RIDGE DR
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City | BALTIMORE
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State | MD
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Zip | 21209-1844
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Country | US
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Telephone | 443-610-9926
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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 | LGP8209
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License Number State | MD
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