Provider Demographics
NPI:1285832337
Name:LIBMAN, DANA (AUD)
Entity Type:Individual
Prefix:
First Name:DANA
Middle Name:
Last Name:LIBMAN
Suffix:
Gender:F
Credentials:AUD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1424 DIAMOND HEAD CIR
Mailing Address - Street 2:
Mailing Address - City:DECATUR
Mailing Address - State:GA
Mailing Address - Zip Code:30033-2304
Mailing Address - Country:US
Mailing Address - Phone:404-992-6134
Mailing Address - Fax:
Practice Address - Street 1:36 LINDEN AVENUE
Practice Address - Street 2:EMORY HEAD AND NECK PROGRAM
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30308
Practice Address - Country:US
Practice Address - Phone:404-778-0278
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-07-10
Last Update Date:2023-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAY1385231H00000X
GAAUD004362231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist