Individual
MARY CYNTHIA LIEBLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RD
Contact information
Practice address
303 N CLYDE MORRIS BLVD, DAYTONA BEACH, FL 32114-2709
(386) 254-4165
Mailing address
303 N CLYDE MORRIS BLVD, DAYTONA BEACH, FL 32114-2709
(386) 254-4165
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
ND651
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
ND651
STATE LICENSE NUMBER
FL
Enumeration date
11/01/2006
Last updated
07/08/2007
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