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General NPI Number Information
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NPI Number | 1932573078
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Entity Type | Individual
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Provider Name | REBECCA LIEBERMAN LMT
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Gender | Female
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Dates
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Enumeration Date | 11/28/2015
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Last Update Date | 11/28/2015
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Provider Practice Location Address
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Address Line | 34921 US HIGHWAY 19 N # 150
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City | PALM HARBOR
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State | FL
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Zip | 34684-1969
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Country | US
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Telephone | 561-318-1115
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Fax |
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Provider Business Mailing Address
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Address Line | 39650 US HIGHWAY 19 N APT 736
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City | TARPON SPGS
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State | FL
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Zip | 34689-3912
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Country | US
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Telephone | 561-318-1115
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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 | 225700000X
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Taxonomy Name | Massage Therapist
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License Number | MA34918
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License Number State | FL
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