Individual
JAY F LOGAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LSCSW
Contact information
Practice address
2537 EISENHOWER RD, OTTAWA, KS 66067-9482
(785) 242-3780
(785) 242-6397
Mailing address
PO BOX 677, OTTAWA, KS 66067-0677
(785) 242-3780
(785) 242-6397
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
LSCSW 2285
KS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200431410A
—
KS
Enumeration date
01/22/2007
Last updated
04/28/2011
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