Individual
MRS. BROOKS MARIE LIEDERBACH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
1451 LUCAS RD, MANSFIELD, OH 44903-8682
(419) 589-5511
(419) 589-7381
Mailing address
1451 LUCAS RD, MANSFIELD, OH 44903-8682
(419) 589-5511
(419) 589-7381
Taxonomy
Speciality
Code
Description
License number
State
323P00000X
Psychiatric Residential Treatment Facility
Primary
138428.MEDS-IV
OH
Other
Enumeration date
01/26/2017
Last updated
01/26/2017
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