Healthcare Provider Details

I. General information

NPI: 1255127783
Provider Name (Legal Business Name): CHRISTI GATES LIEBE M.A. CCC-SLP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/21/2025
Last Update Date: 04/21/2025
Certification Date: 04/20/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

505 E RIDGEWOOD ST
ORLANDO FL
32803-5699
US

IV. Provider business mailing address

2107 RICKOVER PL
WINTER GARDEN FL
34787-5486
US

V. Phone/Fax

Practice location:
  • Phone: 407-496-9995
  • Fax:
Mailing address:
  • Phone: 407-496-9995
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License NumberSA14255
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: