Individual
MRS. STACEY LAUREL LIEBROSS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.S. CCC-SLP, BCBA
Contact information
Practice address
109 BEAGLE DR, MANALAPAN, NJ 07726-8818
(732) 605-0567
(732) 605-0568
Mailing address
109 BEAGLE DR, MANALAPAN, NJ 07726-8818
(732) 605-0567
(732) 605-0568
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
1-07-3858
FL
235Z00000X
Speech-Language Pathologist
Primary
41YS00366800
NJ
Other
Enumeration date
07/03/2012
Last updated
07/03/2012
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