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1154003713
DAVANTE LOGAN
ANTIOCH, CA
NPI
1154003713
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
106S00000X Behavior Technician
Enumeration Date
2023-08-03
Last Update Date
2023-08-03
Business Address
DAVANTE LOGAN
4849 LONE TREE WAY SUITE C
ANTIOCH, CA 94531-8644
Phone number: 303-989-8169
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Mailing Address
DAVANTE LOGAN
4849 LONE TREE WAY SUITE C
ANTIOCH, CA 94531-8644
Phone number:
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