Individual
GERALD LIEBERG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
SLP
Contact information
Practice address
114 S 20TH AVE W, SUITE A, DULUTH, MN 55806-3526
(218) 721-4732
Mailing address
114 S 20TH AVE W, SUITE A, DULUTH, MN 55806-3526
(218) 721-4732
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
5157
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
41D93LI
BCBS
MN
05
—
616055700
—
MN
01
—
HP45807
HEALTH PARTNERS
MN
Enumeration date
09/28/2006
Last updated
03/28/2017
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