| NPI | 1295703924 |
|---|---|
| Former Name | JOAN LOGAN |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 364SP0813X Clinical Nurse Specialist Psychiatric/Mental Health, Geropsychiatric |
| Additional Taxonomies | 101YP2500X Counselor Professional (Licence: CO 234) |
| 163W00000X Registered Nurse (Licence: CO 65018) | |
| Enumeration Date | 2006-03-09 |
| Last Update Date | 2008-02-26 |