Doctor Name: | MRS. JEANNINE LISA LIEBMANN |
NPI Number: | 1912238254 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | MA. LPC |
License Number: | 2005030086-LICENSED |
Business Practice Address: | 791 New Beginnings Dr. Pacific, MO - 63069 |
Business Phone Number: | 3145373548 |
Business Fax Number: | |
Mailing Address: | 313 Walloch Dr., EUREKA |
State: | MO |
Postal Code: | 63025 |
Phone Number: | 3145373548 |
Fax Number: | |
NPI Enumeration Date: | 01/27/2010 |
NPI Last Update Date: | 01/27/2010 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YP2500X |
License Number: | 2005030086-LICENSED |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | MO |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Professional |
Taxonomy Definition: |