Doctor Name: | LISA J LIEBERMAN |
NPI Number: | 1558503920 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | CCC/SLP |
License Number: | SA9330 |
Business Practice Address: | 3012 Cypress Creek Dr E Ponte Vedra Beach, FL - 320823012 |
Business Phone Number: | 6147465737 |
Business Fax Number: | 9048343065 |
Mailing Address: | 3012 Cypress Creek Dr E, PONTE VEDRA BEACH |
State: | FL |
Postal Code: | 320823012 |
Phone Number: | 6147465737 |
Fax Number: | 9048343065 |
NPI Enumeration Date: | 04/01/2009 |
NPI Last Update Date: | 06/20/2011 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 235Z00000X |
License Number: | SA9330 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | FL |
Taxonomy Type: | Speech, Language and Hearing Service Providers |
Taxonomy Classification: | Speech-Language Pathologist |
Taxonomy Specialization: | |
Taxonomy Definition: | A speech pathologist is a person qualified by a master |