Provider Demographics
NPI:1033187083
Name:LIBERI, KAREN HELEN (KAREN LIBERI)
Entity type:Individual
Prefix:MRS
First Name:KAREN
Middle Name:HELEN
Last Name:LIBERI
Suffix:
Gender:F
Credentials:KAREN LIBERI
Other - Prefix:
Other - First Name:KAREN
Other - Middle Name:
Other - Last Name:SULLIVAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MS, MPT, WCS
Mailing Address - Street 1:6005 MONCLOVA RD STE 320
Mailing Address - Street 2:
Mailing Address - City:MAUMEE
Mailing Address - State:OH
Mailing Address - Zip Code:43537-1862
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:3806 HILLSIDE CT
Practice Address - Street 2:
Practice Address - City:ADRIAN
Practice Address - State:MI
Practice Address - Zip Code:49221-9013
Practice Address - Country:US
Practice Address - Phone:517-759-4921
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-03-08
Last Update Date:2024-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHPT013275225100000X
MI5501014541225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MEMM9914Medicare ID - Type Unspecified