Provider Demographics
NPI:1508260795
Name:DIAZ-MUNOZ-LAFORGE, MARIBEL XIOMARA (MS, LMHC, LPC)
Entity type:Individual
Prefix:MRS
First Name:MARIBEL
Middle Name:XIOMARA
Last Name:DIAZ-MUNOZ-LAFORGE
Suffix:
Gender:F
Credentials:MS, LMHC, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7470 N 37TH ST
Mailing Address - Street 2:
Mailing Address - City:RICHLAND
Mailing Address - State:MI
Mailing Address - Zip Code:49083-9691
Mailing Address - Country:US
Mailing Address - Phone:269-449-1667
Mailing Address - Fax:
Practice Address - Street 1:7470 N 37TH ST
Practice Address - Street 2:
Practice Address - City:RICHLAND
Practice Address - State:MI
Practice Address - Zip Code:49083-9691
Practice Address - Country:US
Practice Address - Phone:269-449-1667
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-10-16
Last Update Date:2023-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health