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Individual

LOGAN JAMES MILES

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
441 E BROAD ST STE P, COOKEVILLE, TN 38501-3390
(615) 549-7740
Mailing address
1054 WALTON LN, COOKEVILLE, TN 38501-1863
(615) 549-7740

Taxonomy

Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
5264
TN

Other

Enumeration date
01/03/2024
Last updated
01/03/2024
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