Organization
DIAGON THERAPUTIC LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. TRACI SCOTT MORROW (THERAPIST)
(704) 890-2192
Entity
Organization
Contact information
Practice address
413 W MAIN AVE, SUITE 120, GASTONIA, NC 28052-3896
(704) 890-2192
(704) 974-6213
Mailing address
296 SACCO ST, BELMONT, NC 28012-3059
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
6115013
—
NC
Enumeration date
08/01/2012
Last updated
08/03/2012
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