Provider Demographics
NPI:1972073658
Name:GIDDENS, NONA R
Entity Type:Individual
Prefix:
First Name:NONA
Middle Name:R
Last Name:GIDDENS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6095 GLACIER RUN
Mailing Address - Street 2:
Mailing Address - City:NORCROSS
Mailing Address - State:GA
Mailing Address - Zip Code:30093-5447
Mailing Address - Country:US
Mailing Address - Phone:256-655-2615
Mailing Address - Fax:
Practice Address - Street 1:6095 GLACIER RUN
Practice Address - Street 2:
Practice Address - City:NORCROSS
Practice Address - State:GA
Practice Address - Zip Code:30093-5447
Practice Address - Country:US
Practice Address - Phone:256-655-2615
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-11-26
Last Update Date:2023-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health