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Individual

DR. LEWIS E LOGAN II

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
MDIV, THM, DMIN, CPE

Contact information

Practice address
332 N. PRAIRIE AVE., SUITE 417, INGLEWOOD, CA 90301
(310) 680-1810
Mailing address
10747 MAGNOLIA BLVD, 418, NORTH HOLLYWOOD, CA 91601-4093
(310) 936-7703

Taxonomy

Speciality
Code
Description
License number
State
101YP1600X
Pastoral Counselor
Primary

Other

Enumeration date
03/06/2017
Last updated
03/06/2017
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