| NPI | 1487465779 |
|---|---|
| Former Name | AMANDA J LOGAN |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: NY 099200) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: NY 37633) |
| 104100000X Social Worker (Licence: NY 113012) | |
| Enumeration Date | 2025-01-15 |
| Last Update Date | 2025-01-15 |