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1710765540
AMANDA LOGAN
FLORISSANT, MO
NPI
1710765540
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
363LP0808X Nurse Practitioner, Psych/Mental Health
(Licence: MO 2023022156)
Enumeration Date
2023-09-21
Last Update Date
2024-02-13
Business Address
AMANDA LOGAN PMHNP
1150 GRAHAM RD STE 101&102
FLORISSANT, MO 63031-8077
Phone number: 314-206-3900
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Mailing Address
AMANDA LOGAN PMHNP
3309 S KINGSHIGHWAY BLVD
SAINT LOUIS, MO 63139-1101
Phone number: 314-206-3700
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