Provider Demographics
NPI:1427702851
Name:LOR, GAOSHEN CRISTI
Entity type:Individual
Prefix:
First Name:GAOSHEN
Middle Name:CRISTI
Last Name:LOR
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2904 CEDAR CREEK RD APT 14
Mailing Address - Street 2:
Mailing Address - City:GREENVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:27834-1043
Mailing Address - Country:US
Mailing Address - Phone:828-217-9859
Mailing Address - Fax:
Practice Address - Street 1:90 GUARDIAN CT
Practice Address - Street 2:
Practice Address - City:ROCKY MOUNT
Practice Address - State:NC
Practice Address - Zip Code:27804-3017
Practice Address - Country:US
Practice Address - Phone:252-212-3350
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-02-04
Last Update Date:2022-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCP0146061041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical