Provider Demographics
NPI:1275300220
Name:LIBERTI, ELKE BELLE ANGELLE (LMT)
Entity Type:Individual
Prefix:
First Name:ELKE BELLE
Middle Name:ANGELLE
Last Name:LIBERTI
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3520 CORONA CIR
Mailing Address - Street 2:
Mailing Address - City:ANCHORAGE
Mailing Address - State:AK
Mailing Address - Zip Code:99517-1485
Mailing Address - Country:US
Mailing Address - Phone:907-744-3282
Mailing Address - Fax:
Practice Address - Street 1:1201 HOLLYWOOD DR
Practice Address - Street 2:
Practice Address - City:ANCHORAGE
Practice Address - State:AK
Practice Address - Zip Code:99501-1317
Practice Address - Country:US
Practice Address - Phone:907-744-3282
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-12-11
Last Update Date:2023-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK213554225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist