Individual
LILLY LIBERTY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1540 S 70TH ST STE 100, LINCOLN, NE 68506-1575
(818) 401-0661
Mailing address
16380 ROSCOE BLVD STE 100, VAN NUYS, CA 91406-1221
(818) 401-0661
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
06/05/2025
Last updated
06/05/2025
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