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Individual

MS. JAMIE M LOGAN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
LISAC, LADC

Contact information

Practice address
7000, 2 AZ-179 D200, SUITE 5, SEDONA, AZ 86351-9033
(928) 662-9978
Mailing address
PO BOX 21113, SEDONA, AZ 86341-1113
(928) 662-9978

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
15103
AZ
101YA0400X
Addiction (Substance Use Disorder) Counselor
936
OK

Other

Enumeration date
03/23/2010
Last updated
09/14/2021
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