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1952704066
STEPHANIE LOGAN
ALTON, IL
NPI
1952704066
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
101YM0800X Counselor, Mental Health
Enumeration Date
2014-10-02
Last Update Date
2014-10-02
Business Address
-- STEPHANIE LOGAN
1734 MAIN ST
ALTON, IL 62002-4709
Phone number: 618-465-8623
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Mailing Address
-- STEPHANIE LOGAN
2615 EDWARDS ST
ALTON, IL 62002-3915
Phone number: 618-462-2331
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