Individual
GRZEGORZ LIBERADZKI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PSYD
Contact information
Practice address
650 JOEL DR, FORT CAMPBELL, KY 42223-5318
(270) 798-8967
Mailing address
650 JOEL DR, FORT CAMPBELL, KY 42223-5318
(270) 798-8967
(270) 956-0219
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
655
WY
390200000X
Student in an Organized Health Care Education/Training Program
655
WY
Other
Enumeration date
08/31/2016
Last updated
02/26/2025
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