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General NPI Number Information
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NPI Number | 1164721684
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Entity Type | Organization
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Legal Business Name | MARY LIEBERMANN, INC.
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Dates
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Enumeration Date | 03/23/2011
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Last Update Date | 03/24/2023
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Provider Practice Location Address
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Address Line | 1307 PORTLAND AVE
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City | ORLANDO
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State | FL
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Zip | 32803-2620
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Country | US
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Telephone | 407-719-7749
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Fax |
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Provider Business Mailing Address
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Address Line | 1307 PORTLAND AVE
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City | ORLANDO
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State | FL
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Zip | 32803-2620
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Country | US
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Telephone | 407-719-7749
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Fax |
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Authorized Official
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Title or Position | PRESIDENT/PSYCHOTHERAPIST
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Name | MARY LIEBERMANN
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Credential |
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Telephone | 321-306-7830
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | SW3109
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License Number State | FL
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