Provider Demographics
NPI:1235006677
Name:THIAGO-MUNOZ, MARAIZA
Entity type:Individual
Prefix:
First Name:MARAIZA
Middle Name:
Last Name:THIAGO-MUNOZ
Suffix:
Gender:X
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:205 DEVELIN DR
Mailing Address - Street 2:
Mailing Address - City:PHOENIXVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:19460-1519
Mailing Address - Country:US
Mailing Address - Phone:610-554-9597
Mailing Address - Fax:
Practice Address - Street 1:205 DEVELIN DR
Practice Address - Street 2:
Practice Address - City:PHOENIXVILLE
Practice Address - State:PA
Practice Address - Zip Code:19460-1519
Practice Address - Country:US
Practice Address - Phone:610-554-9597
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-10-21
Last Update Date:2025-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174N00000XOther Service ProvidersLactation Consultant, Non-RN