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1366122681
DOMINGA LOGAN
BROCKTON, MA
NPI
1366122681
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
101YM0800X Counselor, Mental Health
Enumeration Date
2023-07-21
Last Update Date
2023-07-21
Business Address
DOMINGA LOGAN
103 COMMERCIAL STREET FLOOR 3
BROCKTON, MA 02302
Phone number: 508-580-4691
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Mailing Address
DOMINGA LOGAN
103 COMMERCIAL STREET 3RD FLOOR,
BROCKTON, MA 02302
Phone number:
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