| Doctor Name: | DR. BETHANY A. LIEBERMAN |
| NPI Number: | 1396984548 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | PSY.D. |
| License Number: | 0480000920 |
| Business Practice Address: | 15 Pinecrest Dr Essex Junction, VT - 054522912 |
| Business Phone Number: | 8022881087 |
| Business Fax Number: | 8028784404 |
| Mailing Address: | 86 Lake St, BURLINGTON |
| State: | VT |
| Postal Code: | 054015297 |
| Phone Number: | 8028653450 |
| Fax Number: | 8028605011 |
| NPI Enumeration Date: | 02/11/2009 |
| NPI Last Update Date: | 02/11/2009 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 103TC0700X |
| License Number: | 0480000920 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | VT |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Psychologist |
| Taxonomy Specialization: | Clinical |
| Taxonomy Definition: | |