Active NPI
Deanna Liederbach
- Occupational Therapist
- Kensington, MD
National Provider Identifier
1336977792
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- 05809
- Practice address
- 3805 Saul Rd
Kensington, MD 20895-3440 - Phone
- (414) 231-0284
- NPI assigned
- Jul 25, 2024
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Occupational Therapist | 225X00000X | 05809 | MD | Primary |
Addresses
Primary practice location
3805 Saul Rd
Kensington, MD 20895-3440
Mailing address
5618 S 110TH St
Hales Corners, WI 53130-1839
Phone (414) 231-0284
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 05809 | MD | MD | Occupational Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1721865600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1721865600000",
"number": "1336977792",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5618 S 110TH ST",
"city": "HALES CORNERS",
"state": "WI",
"postal_code": "531301839",
"telephone_number": "414-231-0284"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3805 SAUL RD",
"city": "KENSINGTON",
"state": "MD",
"postal_code": "208953440",
"telephone_number": "414-231-0284"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LIEDERBACH",
"first_name": "DEANNA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2024-07-25",
"last_updated": "2024-07-25",
"certification_date": "2024-07-25",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "MD",
"license": "05809",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Kensington, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 25, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.