ISAIAH LOGAN

CERES, CA
NPI1053825414
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy101YA0400X Counselor, Addiction (Substance Use Disorder)
Enumeration Date2017-11-21
Last Update Date2017-11-21
Business Address
Mr. ISAIAH LOGAN
1904 RICHLAND AVE
CERES, CA 95307-4562
Phone number: 209-541-2121
Mailing Address
Mr. ISAIAH LOGAN
1904 RICHLAND AVE
CERES, CA 95307-4562
Phone number:
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