NPI | 1386526911 |
---|---|
Other Name | SAGE LOGAN |
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 101YM0800X Counselor, Mental Health |
Additional Taxonomies | 101YP2500X Counselor, Professional |
Enumeration Date | 2025-07-24 |
Last Update Date | 2025-08-06 |