Provider Demographics
NPI:1578051322
Name:DIGGS, HEATHER (MS)
Entity type:Individual
Prefix:
First Name:HEATHER
Middle Name:
Last Name:DIGGS
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3188 SUMNER RD
Mailing Address - Street 2:
Mailing Address - City:BOYNE CITY
Mailing Address - State:MI
Mailing Address - Zip Code:49712-8809
Mailing Address - Country:US
Mailing Address - Phone:231-350-2903
Mailing Address - Fax:
Practice Address - Street 1:704 EMMET ST
Practice Address - Street 2:
Practice Address - City:PETOSKEY
Practice Address - State:MI
Practice Address - Zip Code:49770-2910
Practice Address - Country:US
Practice Address - Phone:231-347-5511
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-04-27
Last Update Date:2024-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6851117789104100000X
103TA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TA0400XBehavioral Health & Social Service ProvidersPsychologistAddiction (Substance Use Disorder)
No104100000XBehavioral Health & Social Service ProvidersSocial Worker