Individual
MARCELLA SUZANNE LOGAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MSW, LICSW
Contact information
Practice address
4313 6TH AVE SE STE C, LACEY, WA 98503-1072
(360) 791-1234
Mailing address
PO BOX 2639, OLYMPIA, WA 98507-2639
(360) 791-1234
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
LW60728277
WA
Other
Enumeration date
08/09/2018
Last updated
08/09/2018
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