Individual
MRS. LIZA MORAN FERNANDEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
120 HANDLEY RD STE 310, TYRONE, GA 30290-2173
(404) 644-9244
(770) 632-6351
Mailing address
104 KIMMER RD, PEACHTREE CITY, GA 30269-3633
(404) 644-9244
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
CSW002573
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000847569B
—
GA
Enumeration date
03/06/2007
Last updated
03/31/2011
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