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Individual
JUDI L. LEIBROCK
Active
Individual
JUDI L. LEIBROCK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LMHP, LADC
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
2409
NE
101Y00000X
Counselor
546
NE
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2409
LMHP LICENSE
NE
01
—
546
LADC LICENSE
NE
Enumeration date
03/26/2007
Last updated
07/08/2007
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