MEDICARE: KRISTINA MARIS LIEBERT

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	235Z00000X	Speech-Language Pathologist

General Provider Information

NPI Number	:	1568394336
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KRISTINA MARIS LIEBERT

Provider Business Mailing Address
First Line	:	1919 MADISON AVE UNIT B
Second Line	:
City	:	AUSTIN
State	:	TX
Zip	:	78757-2222
Country	:	US
Telephone Number	:	512-517-3370
Fax Number	:

Provider Business Practice Location Address
First Line	:	1919 MADISON AVE UNIT B
Second Line	:
City	:	AUSTIN
State	:	TX
Zip	:	78757-2222
Country	:	US
Telephone Number	:	512-517-3370
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/03/2026
Last Update Date	:	06/03/2026

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Directions to “ KRISTINA MARIS LIEBERT ” Practice Location

Language	Start Address	Practice Location

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