Individual
ALICE Q LIBET
Active
Sole proprietor
Provider details
NPI number
Gender
F
Credential
PHD
Contact information
Practice address
171 ASHLEY AVE, CHARLESTON, SC 29425-0001
(843) 792-1414
Mailing address
PO BOX 751461, CHARLOTTE, NC 28275-1461
(843) 792-6200
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
321
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
PS0287
—
SC
Enumeration date
06/14/2006
Last updated
07/08/2007
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