Provider Demographics
NPI:1184382061
Name:LIEB, ABIGAIL (LISW)
Entity type:Individual
Prefix:
First Name:ABIGAIL
Middle Name:
Last Name:LIEB
Suffix:
Gender:F
Credentials:LISW
Other - Prefix:
Other - First Name:ABIGAIL
Other - Middle Name:
Other - Last Name:RAHLF
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LISW
Mailing Address - Street 1:2223 KEY WAY STE A
Mailing Address - Street 2:
Mailing Address - City:DUBUQUE
Mailing Address - State:IA
Mailing Address - Zip Code:52002-3857
Mailing Address - Country:US
Mailing Address - Phone:563-556-5000
Mailing Address - Fax:
Practice Address - Street 1:2223 KEY WAY STE A
Practice Address - Street 2:
Practice Address - City:DUBUQUE
Practice Address - State:IA
Practice Address - Zip Code:52002-3857
Practice Address - Country:US
Practice Address - Phone:563-556-5000
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-12-07
Last Update Date:2022-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA0961001041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical