Organization
LEWIS R. LIEBERMAN, INCORPORATED
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LEWIS ROBERT LIEBERMAN PH. D. (SECRETARY/TREASURER)
(706) 561-4625
Entity
Organization
Contact information
Practice address
1501 13TH ST, SUITE J, COLUMBUS, GA 31901-2383
(706) 315-1862
Mailing address
5701 SHERBORNE DR, COLUMBUS, GA 31909-4740
(706) 561-4625
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
205
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000052401B
—
GA
Enumeration date
11/06/2009
Last updated
11/06/2009
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