| Diagon Theraputic Llc | |
|
413 W Main Ave Suite 120 Gastonia NC 28052-3896 | |
| (704) 890-2192 | |
| (704) 974-6213 |
| Full Name | Diagon Theraputic Llc |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 413 W Main Ave, Gastonia, North Carolina |
| Authorized Official Name and Position | Traci Scott Morrow (THERAPIST) |
| Authorized Official Contact | 7048902192 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Diagon Theraputic Llc 296 Sacco St Belmont NC 28012-3059 Ph: () - | Diagon Theraputic Llc 413 W Main Ave Suite 120 Gastonia NC 28052-3896 Ph: (704) 890-2192 |
| NPI Number | 1235485871 |
|---|---|
| Provider Enumeration Date | 08/01/2012 |
| Last Update Date | 08/03/2012 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1235485871 | NPI | - | NPPES |
| 6115013 | Medicaid | NC |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
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