Provider Demographics
NPI:1801547575
Name:WALDON, DIANTE (CADC-II)
Entity type:Individual
Prefix:MR
First Name:DIANTE
Middle Name:
Last Name:WALDON
Suffix:
Gender:M
Credentials:CADC-II
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:621 CARVER RD
Mailing Address - Street 2:
Mailing Address - City:GRIFFIN
Mailing Address - State:GA
Mailing Address - Zip Code:30224-3937
Mailing Address - Country:US
Mailing Address - Phone:678-972-9180
Mailing Address - Fax:
Practice Address - Street 1:621 CARVER RD
Practice Address - Street 2:
Practice Address - City:GRIFFIN
Practice Address - State:GA
Practice Address - Zip Code:30224-3937
Practice Address - Country:US
Practice Address - Phone:678-972-9180
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-01-14
Last Update Date:2022-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)