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General NPI Number Information
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NPI Number | 1356360846
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Entity Type | Individual
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Provider Name | DALE N. LIEBMAN LCSW-C
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Gender | Female
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Dates
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Enumeration Date | 07/18/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 104 CHURCH LN STE.206
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City | PIKESVILLE
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State | MD
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Zip | 21208-3786
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Country | US
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Telephone | 410-484-7024
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Fax | 410-653-5215
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Provider Business Mailing Address
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Address Line | 3704 BIRCHMERE CT
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City | OWINGS MILLS
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State | MD
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Zip | 21117-1256
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Country | US
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Telephone | 410-356-3056
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Fax | 410-653-5215
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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 | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 02757
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License Number State | MD
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