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Individual

KEN LIEBERMAN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.A

Contact information

Practice address
1100 POINTE NEWPORT TER APT 104, CASSELBERRY, FL 32707-7247
(772) 453-3967
Mailing address
1100 POINTE NEWPORT TER APT 104, CASSELBERRY, FL 32707-7247
(772) 453-3967

Taxonomy

Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
IMH9587
FL

Other

Enumeration date
06/03/2013
Last updated
06/03/2013
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