Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 175F00000X | Naturopath | 5.000673 | CT |
NPI | 1013519719 |
---|---|
Provider Name | Dr. Katelyn J Lieb |
First Address | Westbrook, CT 06498-2171 |
Second Address | Westbrook, CT 06498-2171 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 09/11/2020 |
Last Update Date | 11/01/2021 |