Provider Demographics
NPI:1235683681
Name:LAGUNAS, MARIBEL (MS SLP-CCC)
Entity Type:Individual
Prefix:
First Name:MARIBEL
Middle Name:
Last Name:LAGUNAS
Suffix:
Gender:F
Credentials:MS SLP-CCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1031 OLDE MILL LN
Mailing Address - Street 2:
Mailing Address - City:HIXSON
Mailing Address - State:TN
Mailing Address - Zip Code:37343-2953
Mailing Address - Country:US
Mailing Address - Phone:256-874-6369
Mailing Address - Fax:
Practice Address - Street 1:600 N HOLTZCLAW AVE
Practice Address - Street 2:SUITE 200
Practice Address - City:CHATTANOOGA
Practice Address - State:TN
Practice Address - Zip Code:37404-1242
Practice Address - Country:US
Practice Address - Phone:423-622-6900
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-08-14
Last Update Date:2016-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN0000005696235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist