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Individual

MRS. DEBORAH LOGAN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
LMFT

Contact information

Practice address
17111 KENTON DR STE 203B, CORNELIUS, NC 28031-5650
(704) 677-4135
Mailing address
113 BUSHNELL PL, MOORESVILLE, NC 28115-8327

Taxonomy

Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
12018A
NC
106H00000X
Marriage & Family Therapist
Primary
2259
NC

Other

Enumeration date
03/09/2017
Last updated
10/19/2022
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