Provider Demographics
NPI:1104007574
Name:BROSBE, LIORA RAHEL ABRAHAMS
Entity Type:Individual
Prefix:MS
First Name:LIORA
Middle Name:RAHEL ABRAHAMS
Last Name:BROSBE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1727 MARTIN LUTHER KING JR WAY
Mailing Address - Street 2:#109
Mailing Address - City:OAKLAND
Mailing Address - State:CA
Mailing Address - Zip Code:94612-1358
Mailing Address - Country:US
Mailing Address - Phone:510-893-9230
Mailing Address - Fax:510-893-2074
Practice Address - Street 1:1727 MARTIN LUTHER KING JR WAY
Practice Address - Street 2:#109
Practice Address - City:OAKLAND
Practice Address - State:CA
Practice Address - Zip Code:94612-1358
Practice Address - Country:US
Practice Address - Phone:510-893-9230
Practice Address - Fax:510-893-2074
Is Sole Proprietor?:No
Enumeration Date:2007-11-14
Last Update Date:2007-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAIMF53136 MFTI106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist