Individual
LEAH LOGAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
223 N 6TH ST STE 405, BOISE, ID 83702-6082
(208) 704-2166
Mailing address
5917 W ROBERTSON DR, BOISE, ID 83709-2166
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
LCSW-36482
ID
Other
Enumeration date
02/03/2014
Last updated
06/13/2023
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