Individual
DR. KENNETH LIEBENAU
Active
Individual
DR. KENNETH LIEBENAU
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHD
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
LP-1019
KS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
11890
PREFERRED HEALTH SYSTEMS
KS
01
—
119713
BLUE CROSS BLUE SHIELD
KS
Enumeration date
05/23/2005
Last updated
08/29/2007
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