Corey Elizabeth Sophia Libera
Student in an Organized Health Care Education/Training Program in Palos Heights, IL. Individual provider (NPI-1).
NPI number1225425986
StatusActive
Last updated in NPPESApr 21, 2015
Details
- NPI
- 1225425986
- Entity type
- Individual (NPI-1)
- Name
- Corey Elizabeth Sophia Libera
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Apr 21, 2015
- Last updated
- Apr 21, 2015
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 390200000X | Student in an Organized Health Care Education/Training Program | – | – | Yes |
| 2255A2300X | Specialist/Technologist, Athletic Trainer | – | – |
Practice location
6220 W 127th PlPalos Heights, IL 60463-2314
Phone 708-337-3048
Mailing address
6220 W 127th PlPalos Heights, IL 60463-2314
Phone 708-337-3048
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