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1104065564
LOGAN M PENCE
EATON, OH
NPI
1104065564
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
101YA0400X Counselor, Addiction (Substance Use Disorder)
(Licence: OH 943841)
Enumeration Date
2009-02-09
Last Update Date
2009-02-09
Business Address
-- LOGAN M PENCE LICDC
228 N BARRON ST
EATON, OH 45320-1704
Phone number: 937-456-7694
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Mailing Address
-- LOGAN M PENCE LICDC
228 N BARRON ST
EATON, OH 45320-1704
Phone number: 937-456-7694
Copy
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