Individual
GARY LIEBERT JR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
CIT
Contact information
Practice address
401 W VERMILION ST, LAFAYETTE, LA 70501-6729
(337) 354-9736
Mailing address
401 W VERMILION ST, LAFAYETTE, LA 70501-6729
(337) 354-9736
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
4247
LA
Other
Enumeration date
04/27/2020
Last updated
04/27/2020
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