Individual
MR. MICHAEL ODELL LOGAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
3455 W CRAIG RD STE C, NORTH LAS VEGAS, NV 89032-5119
(702) 612-5844
(702) 479-7134
Mailing address
3455 WEST CRAIG RD. UNIT C, NORTH LAS VEGAS, NV 89031
(702) 612-5844
(702) 479-7134
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
103K00000X
NV
Other
Enumeration date
08/03/2011
Last updated
08/03/2011
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