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INDEPENDENT EVALUATION SERVICES

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MS. LEIGH MARIE LIBERATORE B.S.W. (CLINIC MANAGER)
(248) 971-2180
Entity
Organization

Contact information

Practice address
30555 SOUTHFIELD RD., 250, SOUTHFIELD, MI 48076
(248) 971-2180
Mailing address
30555 SOUTHFIELD RD., 250, SOUTHFIELD, MI 48076
(248) 971-2180

Taxonomy

Speciality
Code
Description
License number
State
171W00000X
Contractor
Primary
171W00000X
MI

Other

Enumeration date
12/15/2010
Last updated
12/15/2010
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