Individual
LINDA LIEBOLD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1993 SILVER KNIGHT DR, SISTERSVILLE, WV 26175-9600
(304) 758-2145
Mailing address
PO BOX 25, MIDDLEBOURNE, WV 26149-0025
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0155558000
—
WV
Enumeration date
04/01/2008
Last updated
04/01/2008
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