Provider Demographics
NPI:1598506008
Name:LIEBERMAN, DENISE GENEVIE (SLP-CFY)
Entity type:Individual
Prefix:MRS
First Name:DENISE
Middle Name:GENEVIE
Last Name:LIEBERMAN
Suffix:
Gender:F
Credentials:SLP-CFY
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1440 PINE WARBLER PL UNIT 10406
Mailing Address - Street 2:
Mailing Address - City:SARASOTA
Mailing Address - State:FL
Mailing Address - Zip Code:34240-1553
Mailing Address - Country:US
Mailing Address - Phone:818-634-5079
Mailing Address - Fax:
Practice Address - Street 1:1524 S EAST AVE
Practice Address - Street 2:
Practice Address - City:SARASOTA
Practice Address - State:FL
Practice Address - Zip Code:34239-2324
Practice Address - Country:US
Practice Address - Phone:941-365-2422
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-06-06
Last Update Date:2024-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
235Z00000X
FLSZ12111235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist