Individual
BRENNA MARIE LIEBURN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COTA
Contact information
Practice address
1125 N 13TH ST, SHEBOYGAN, WI 53081-3281
(920) 803-1617
Mailing address
1125 N 13TH ST, SHEBOYGAN, WI 53081-3281
(920) 803-1617
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
7074
WI
Other
Enumeration date
06/22/2023
Last updated
06/22/2023
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