Provider Demographics
NPI:1871787333
Name:DIGGS, SHALONDRA BERNICE (LMSW)
Entity type:Individual
Prefix:MS
First Name:SHALONDRA
Middle Name:BERNICE
Last Name: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:PO BOX 31047
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77231-1047
Mailing Address - Country:US
Mailing Address - Phone:520-730-6259
Mailing Address - Fax:
Practice Address - Street 1:22155 WILDWOOD PARK DRIVE
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:TX
Practice Address - Zip Code:77469-5200
Practice Address - Country:US
Practice Address - Phone:520-730-6259
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-08-28
Last Update Date:2007-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXS42303104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker