Provider Demographics
NPI:1669977039
Name:LIBERTO, LEIGH-ANN ELIZABETH (ATC)
Entity type:Individual
Prefix:
First Name:LEIGH-ANN
Middle Name:ELIZABETH
Last Name:LIBERTO
Suffix:
Gender:F
Credentials:ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2508 KENTUCKY CT
Mailing Address - Street 2:
Mailing Address - City:NEW KENSINGTON
Mailing Address - State:PA
Mailing Address - Zip Code:15068-2972
Mailing Address - Country:US
Mailing Address - Phone:724-448-9705
Mailing Address - Fax:
Practice Address - Street 1:2508 KENTUCKY CT
Practice Address - Street 2:
Practice Address - City:NEW KENSINGTON
Practice Address - State:PA
Practice Address - Zip Code:15068-2972
Practice Address - Country:US
Practice Address - Phone:724-448-9705
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-03-28
Last Update Date:2019-05-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program