Individual
CHRISSY LEACH LORT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MSW
Contact information
Practice address
834 WINDING GROVE LN, LOGANVILLE, GA 30052-7015
(678) 933-4292
Mailing address
834 WINDING GROVE LN, LOGANVILLE, GA 30052-7015
(678) 933-4292
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
SC15019
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
SC 15019
SERVICE COORDINATOR CERTIFICATE
GA
Enumeration date
04/29/2015
Last updated
04/29/2015
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