| NPI | 1306104856 |
|---|---|
| Former Name | JENNIFER MARIE LOGAN |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: FL MH11427) |
| Additional Taxonomies | 104100000X Social Worker (Licence: FL CBHCMS100801) |
| Enumeration Date | 2012-05-02 |
| Last Update Date | 2019-05-30 |