Provider Demographics
NPI:1689862971
Name:MONDAY, DIANA MARIE (MA, LLPC)
Entity Type:Individual
Prefix:
First Name:DIANA
Middle Name:MARIE
Last Name:MONDAY
Suffix:
Gender:F
Credentials:MA, LLPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14930 LAPLAISANCE RD STE 123
Mailing Address - Street 2:
Mailing Address - City:MONROE
Mailing Address - State:MI
Mailing Address - Zip Code:48161-3878
Mailing Address - Country:US
Mailing Address - Phone:734-240-3850
Mailing Address - Fax:
Practice Address - Street 1:14930 LAPLAISANCE RD STE 123
Practice Address - Street 2:
Practice Address - City:MONROE
Practice Address - State:MI
Practice Address - Zip Code:48161-3878
Practice Address - Country:US
Practice Address - Phone:734-240-3850
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-10-11
Last Update Date:2007-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI580038101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional