Individual
LOGAN GEORGE BLEAZARD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LCSW
Contact information
Practice address
85 N 300 W STE A, WASHINGTON, UT 84780-3563
(435) 414-8658
(435) 359-5247
Mailing address
85 N 300 W STE A, WASHINGTON, UT 84780-3563
(435) 414-8658
(435) 359-5247
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
9422103-3501
UT
Other
Enumeration date
06/13/2012
Last updated
08/02/2022
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