Provider Demographics
NPI:1225517261
Name:REENA LIBERMAN
Entity Type:Organization
Organization Name:REENA LIBERMAN
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER, PRIVATE PRACTICE
Authorized Official - Prefix:
Authorized Official - First Name:REENA
Authorized Official - Middle Name:
Authorized Official - Last Name:LIBERMAN
Authorized Official - Suffix:
Authorized Official - Credentials:MS
Authorized Official - Phone:734-741-1655
Mailing Address - Street 1:1207 PACKARD ST
Mailing Address - Street 2:
Mailing Address - City:ANN ARBOR
Mailing Address - State:MI
Mailing Address - Zip Code:48104-3810
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1207 PACKARD ST
Practice Address - Street 2:
Practice Address - City:ANN ARBOR
Practice Address - State:MI
Practice Address - Zip Code:48104-3810
Practice Address - Country:US
Practice Address - Phone:734-741-1655
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-08-10
Last Update Date:2018-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty