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1124484274
NIKITA LOGAN
LAFAYETTE, LA
NPI
1124484274
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
1041C0700X Social Worker, Clinical
(Licence: LA 10035)
Enumeration Date
2016-01-05
Last Update Date
2016-01-05
Business Address
-- NIKITA LOGAN
620 E ALEXANDER ST
LAFAYETTE, LA 70501-2304
Phone number: 832-687-2771
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Mailing Address
-- NIKITA LOGAN
PO BOX 62498
LAFAYETTE, LA 70596-2498
Phone number: 832-687-2771
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