Individual
PATRICIA LOGAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PH.D
Contact information
Practice address
2500 N STATE ST, JACKSON, MS 39216-4500
(601) 984-5863
Mailing address
2500 N STATE ST, JACKSON, MS 39216-4500
(601) 984-5863
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
6715
OH
103TC0700X
Clinical Psychologist
Primary
T55974
MS
Other
Enumeration date
09/16/2010
Last updated
12/23/2015
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