Provider Demographics
NPI:1144505777
Name:TAYLOR-DIGGS, KAMIL DENISE (LMSW)
Entity type:Individual
Prefix:
First Name:KAMIL
Middle Name:DENISE
Last Name:TAYLOR-DIGGS
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:182 ODYSSEY TURN
Mailing Address - Street 2:
Mailing Address - City:CONYERS
Mailing Address - State:GA
Mailing Address - Zip Code:30012-3680
Mailing Address - Country:US
Mailing Address - Phone:310-890-1411
Mailing Address - Fax:
Practice Address - Street 1:5255 SNAPFINGER PARK DR STE 120
Practice Address - Street 2:
Practice Address - City:DECATUR
Practice Address - State:GA
Practice Address - Zip Code:30035-4066
Practice Address - Country:US
Practice Address - Phone:678-389-4856
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-10-14
Last Update Date:2019-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
103K00000X
GAMSW008816104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
No103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst