Provider Demographics
NPI:1487148110
Name:SULLIVAN-LIEBERMAN, HANNAH
Entity type:Individual
Prefix:MRS
First Name:HANNAH
Middle Name:
Last Name:SULLIVAN-LIEBERMAN
Suffix:
Gender:F
Credentials:
Other - Prefix:MRS
Other - First Name:HANNAH
Other - Middle Name:
Other - Last Name:BOGDAN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:1450 S LAPEER RD
Mailing Address - Street 2:
Mailing Address - City:OXFORD
Mailing Address - State:MI
Mailing Address - Zip Code:48371-6108
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1350 S LAPEER RD
Practice Address - Street 2:
Practice Address - City:OXFORD
Practice Address - State:MI
Practice Address - Zip Code:48371-6106
Practice Address - Country:US
Practice Address - Phone:248-969-9375
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-06-16
Last Update Date:2018-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst