Provider Demographics
NPI:1295343440
Name:EBER, LIBBY LYN (LMT)
Entity type:Individual
Prefix:MS
First Name:LIBBY
Middle Name:LYN
Last Name:EBER
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:MS
Other - First Name:LIBBY
Other - Middle Name:LYN
Other - Last Name:EBER
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LMT
Mailing Address - Street 1:3045 WEST LIBERTY AVENUE
Mailing Address - Street 2:SUITE #7
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15216
Mailing Address - Country:US
Mailing Address - Phone:412-716-5732
Mailing Address - Fax:
Practice Address - Street 1:3045 WEST LIBERTY AVENUE
Practice Address - Street 2:SUITE #7
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15216
Practice Address - Country:US
Practice Address - Phone:412-716-5732
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-07-14
Last Update Date:2020-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MSG010989225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist