Individual
NANCY A LOGAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHD
Contact information
Practice address
24123 BOERNE STAGE RD, SUITE 430, SAN ANTONIO, TX 78235-9404
(210) 615-0555
(210) 687-1100
Mailing address
24123 BOERNE STAGE RD, SUITE 430, SAN ANTONIO, TX 78235-9404
(210) 615-0555
(210) 687-1100
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
23696
TX
103T00000X
Psychologist
614
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00G66C
BCBS
TX
Enumeration date
07/20/2006
Last updated
05/01/2009
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