Individual
KIM ELLEN LIBERTINI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
245 HILLTOP CT, NEW FREEDOM, PA 17349-9078
(717) 235-6738
Mailing address
245 HILLTOP CT, NEW FREEDOM, PA 17349-9078
(717) 235-6738
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
01264
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00791426
ASHA
—
01
—
01246
STATE LICENSE
MD
Enumeration date
06/14/2019
Last updated
06/14/2019
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