Individual
VANESSA VANCE-LOGAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
400 WEST BUTLER ROAD; SUITE B-1, MAULDIN, SC 29662
(864) 385-5113
(864) 676-9187
Mailing address
PO BOX 567, MAULDIN, SC 29662-0567
(864) 385-5113
(864) 676-9187
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
06/11/2014
Last updated
06/11/2014
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