Individual
JESSICA LIEDERBACH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MT-BC, NMT, NICU-MT
Contact information
Practice address
1879 HAZEL CT, GREEN BAY, WI 54303-6301
(262) 909-5454
Mailing address
1879 HAZEL CT, GREEN BAY, WI 54303-6301
(262) 909-5454
Taxonomy
Speciality
Code
Description
License number
State
225A00000X
Music Therapist
Primary
15333
WI
Other
Enumeration date
01/17/2025
Last updated
01/17/2025
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