Individual
JAMES LOGAN JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1660 VETERANS MEMORIAL BLVD, EUPORA, MS 39744-2048
(662) 258-8147
Mailing address
302 N JACKSON ST, STARKVILLE, MS 39759-2504
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1700894730
MENTAL HEALTH COUNSELOR
MS
Enumeration date
06/12/2023
Last updated
06/12/2023
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