Individual
MARIBEL DIAZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
82683 CODY DR, INDIO, CA 92203-3157
(760) 695-4202
Mailing address
82683 CODY DR, INDIO, CA 92203-3157
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
62147
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
225700000X
MASSAGE THERAPIST
CA
Enumeration date
10/20/2016
Last updated
01/21/2019
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