Provider Demographics
NPI:1245609148
Name:DIGGS, DELIA KEMA (HAIR LOSS SPECIALIST)
Entity Type:Individual
Prefix:
First Name:DELIA
Middle Name:KEMA
Last Name:DIGGS
Suffix:
Gender:F
Credentials:HAIR LOSS SPECIALIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:250 LANGLEY DR
Mailing Address - Street 2:SUITE 1102
Mailing Address - City:LAWRENCEVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30046-6940
Mailing Address - Country:US
Mailing Address - Phone:678-467-6210
Mailing Address - Fax:
Practice Address - Street 1:250 LANGLEY DR
Practice Address - Street 2:SUITE 1102
Practice Address - City:LAWRENCEVILLE
Practice Address - State:GA
Practice Address - Zip Code:30046-6940
Practice Address - Country:US
Practice Address - Phone:678-467-6210
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-09-21
Last Update Date:2015-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GACO0754521744P3200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1744P3200XOther Service ProvidersSpecialistProsthetics Case Management