Provider Demographics
NPI:1750756599
Name:LIBER, LINDSEY SUAREZ (CCC-SLP)
Entity type:Individual
Prefix:MRS
First Name:LINDSEY
Middle Name:SUAREZ
Last Name:LIBER
Suffix:
Gender:F
Credentials:CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3407 PRIMROSE LANE
Mailing Address - Street 2:
Mailing Address - City:YPSILANTI
Mailing Address - State:MI
Mailing Address - Zip Code:48197
Mailing Address - Country:US
Mailing Address - Phone:770-354-3408
Mailing Address - Fax:
Practice Address - Street 1:3407 PRIMROSE LN
Practice Address - Street 2:
Practice Address - City:YPSILANTI
Practice Address - State:MI
Practice Address - Zip Code:48197-3217
Practice Address - Country:US
Practice Address - Phone:770-354-3408
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-12-04
Last Update Date:2017-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GASLP008637235Z00000X
MI7101004863235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist