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General NPI Number Information
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NPI Number | 1336512268
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Entity Type | Individual
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Provider Name | EMILY LIBURDI DIPL. OM R.AC
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Gender | Female
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Dates
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Enumeration Date | 10/30/2015
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Last Update Date | 10/30/2015
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Provider Practice Location Address
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Address Line | 45163 CASS AVE
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City | UTICA
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State | MI
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Zip | 48317-5508
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Country | US
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Telephone | 586-221-0650
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Fax |
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Provider Business Mailing Address
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Address Line | 8989 18 MILE RD
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City | STERLING HTS
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State | MI
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Zip | 48313-3206
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Country | US
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Telephone | 586-489-8867
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 171100000X
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Taxonomy Name | Acupuncturist
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License Number | 5401000017
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License Number State | MI
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