Individual
DAVIS LOGAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
SWLC, MSW
Contact information
Practice address
14 CHARIS LN, MISSOULA, MT 59802-3516
(313) 802-1073
Mailing address
14 CHARIS LN, MISSOULA, MT 59802-3516
(313) 802-1073
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
44181
MT
Other
Enumeration date
10/27/2021
Last updated
10/27/2021
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