Provider Demographics
NPI:1235872029
Name:SARGENT, LILIANA (BS)
Entity Type:Individual
Prefix:
First Name:LILIANA
Middle Name:
Last Name:SARGENT
Suffix:
Gender:F
Credentials:BS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:110 HIGHLAND AVE APT 1
Mailing Address - Street 2:
Mailing Address - City:FORT MITCHELL
Mailing Address - State:KY
Mailing Address - Zip Code:41017-2903
Mailing Address - Country:US
Mailing Address - Phone:859-905-7577
Mailing Address - Fax:
Practice Address - Street 1:8140 DREAM ST
Practice Address - Street 2:
Practice Address - City:FLORENCE
Practice Address - State:KY
Practice Address - Zip Code:41042-7531
Practice Address - Country:US
Practice Address - Phone:859-436-8382
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-04-19
Last Update Date:2022-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator