| Doctor Name: | MRS. MARYANN C LIEBERMAN |
| NPI Number: | 1104943307 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | RLCSW |
| License Number: | R050261-1 |
| Business Practice Address: | 193 Griffing Ave St A Riverhead, NY - 11901 |
| Business Phone Number: | 6317277225 |
| Business Fax Number: | 6317274034 |
| Mailing Address: | Po Box 667, AQUEBOGUE |
| State: | NY |
| Postal Code: | 119310667 |
| Phone Number: | 6317277225 |
| Fax Number: | 6317274034 |
| NPI Enumeration Date: | 03/23/2007 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 1041C0700X |
| License Number: | R050261-1 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | NY |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Social Worker |
| Taxonomy Specialization: | Clinical |
| Taxonomy Definition: | A social worker who holds a master |