| NPI | 1386526911 |
|---|---|
| Other Name | SAGE LOGAN |
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health |
| Additional Taxonomies | 101YP2500X Counselor, Professional |
| Enumeration Date | 2025-07-24 |
| Last Update Date | 2026-03-24 |