Individual
MRS. LAURA LILLIEBJERG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.S.
Contact information
Practice address
4601 N 34TH ST, PHOENIX, AZ 85018-3320
(602) 381-6160
(602) 381-6170
Mailing address
4441 E STANFORD AVE, HIGLEY, AZ 85236-3467
(480) 540-4990
Taxonomy
Speciality
Code
Description
License number
State
251300000X
Local Education Agency (LEA)
Primary
—
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
705121
—
AZ
Enumeration date
02/02/2007
Last updated
07/25/2007
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