Provider Demographics
NPI:1699034298
Name:LOTT, GARRETT LOGAN
Entity Type:Individual
Prefix:MR
First Name:GARRETT
Middle Name:LOGAN
Last Name:LOTT
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1137 JEFFERSON RD
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15235-4725
Mailing Address - Country:US
Mailing Address - Phone:412-818-0284
Mailing Address - Fax:
Practice Address - Street 1:225 ALCOMA BLVD
Practice Address - Street 2:
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15235-2132
Practice Address - Country:US
Practice Address - Phone:412-818-0284
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-05-16
Last Update Date:2012-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker