Provider Demographics
NPI:1457752867
Name:LEIBERT, DANIELLE HEATHER (MS SLP , TSSLD)
Entity Type:Individual
Prefix:MS
First Name:DANIELLE
Middle Name:HEATHER
Last Name:LEIBERT
Suffix:
Gender:F
Credentials:MS SLP , TSSLD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9 COLLINGSWOOD RD
Mailing Address - Street 2:
Mailing Address - City:NEW CITY
Mailing Address - State:NY
Mailing Address - Zip Code:10956-3911
Mailing Address - Country:US
Mailing Address - Phone:845-642-6173
Mailing Address - Fax:
Practice Address - Street 1:9 COLLINGSWOOD RD
Practice Address - Street 2:
Practice Address - City:NEW CITY
Practice Address - State:NY
Practice Address - Zip Code:10956-3911
Practice Address - Country:US
Practice Address - Phone:845-642-6173
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-09-05
Last Update Date:2014-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY023953235Z00000X
NY023953-1235Z00000X
CT004876235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist