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Individual
LOGAN MICHAEL MCINTOSH
Active
Individual
LOGAN MICHAEL MCINTOSH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LCSW
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
0009921493
CO
1041C0700X
Clinical Social Worker
Primary
CSW.09926227
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1982113619
NPI
—
Enumeration date
09/26/2017
Last updated
10/07/2019
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