Individual
MR. PARKER LOGUE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
20 FOX RD, WALTHAM, MA 02451-1007
(508) 975-1299
Mailing address
20 FOX RD, WALTHAM, MA 02451-1007
(508) 975-1299
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
228952
MA
Other
Enumeration date
01/06/2025
Last updated
01/06/2025
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