Individual
ANDREA DIGGS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
584 ROSEBERRY ST, PHILLIPSBURG, NJ 08865-2670
(973) 968-0724
Mailing address
15 RICORD ST, NEWARK, NJ 07106-2003
(862) 588-7566
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
811778823
IRS
—
Enumeration date
02/06/2017
Last updated
07/20/2020
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