Individual
DR. DIANE LOGAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHD, CSAC
Contact information
Practice address
75-5751 KUAKINI HWY STE 104, KAILUA KONA, HI 96740-1705
(808) 326-5629
Mailing address
PO BOX 5488, KAILUA KONA, HI 96745-5488
(808) 785-5443
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
2055-19
HI
101YA0400X
Addiction (Substance Use Disorder) Counselor
2055-19I
HI
103TC0700X
Clinical Psychologist
Primary
PSY-1550
HI
Other
Enumeration date
02/10/2015
Last updated
03/15/2020
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