| Doctor Name: | MS. LAUREN RAE LIBERTY |
| NPI Number: | 1609092212 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | LCSW |
| License Number: | LCS 22803 |
| Business Practice Address: | 10400 Fricot City Rd San Andreas, CA - 952499642 |
| Business Phone Number: | 2093043986 |
| Business Fax Number: | |
| Mailing Address: | Po Box 2121, SAN ANDREAS |
| State: | CA |
| Postal Code: | 952492121 |
| Phone Number: | 2093043986 |
| Fax Number: | |
| NPI Enumeration Date: | 04/18/2007 |
| NPI Last Update Date: | 11/08/2011 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 1041C0700X |
| License Number: | LCS 22803 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | CA |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Social Worker |
| Taxonomy Specialization: | Clinical |
| Taxonomy Definition: | A social worker who holds a master |