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1184274607
LOGAN JADE GASKO
TROY, MI
NPI
1184274607
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
103TC0700X Psychologist Clinical
(Licence: MI 6301018085)
Enumeration Date
2019-09-17
Last Update Date
2019-09-17
Business Address
LOGAN JADE GASKO MA
1777 AXTELL DR STE 100
TROY, MI 48084-4400
Phone number: 248-613-5377
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Mailing Address
LOGAN JADE GASKO MA
19188 SOUTHAMPTON DR
LIVONIA, MI 48152-4106
Phone number: 248-444-3250
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