Individual
LATOSIA RENA-DENISE LOGAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
45964 BRENTWOOD ST, MACOMB, MI 48042-5410
(586) 948-0665
Mailing address
45964 BRENTWOOD ST, MACOMB, MI 48042-5410
(586) 948-0665
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
6451019460
MI
101YP2500X
Professional Counselor
Primary
6451019460
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
38-3242727
—
MI
Enumeration date
05/03/2022
Last updated
02/19/2026
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