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General NPI Number Information
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NPI Number | 1891075297
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Entity Type | Individual
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Provider Name | ANNA CONSTANCE LIEBER MS
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Gender | Female
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Dates
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Enumeration Date | 08/17/2011
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Last Update Date | 12/17/2012
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Provider Practice Location Address
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Address Line | 6780 PATANIA WAY
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City | JACKSONVILLE
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State | FL
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Zip | 32216-5798
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Country | US
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Telephone | 904-805-0850
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Fax | 904-805-9925
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Provider Business Mailing Address
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Address Line | 2001 HODGES BLVD APT 1518
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City | JACKSONVILLE
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State | FL
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Zip | 32224-3050
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Country | US
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Telephone | 801-556-1202
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Fax | 904-805-9925
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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 | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | MH 11498
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License Number State | FL
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