Individual
DR. JADE LOGAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PH.D., ABPP
Contact information
Practice address
255 S 17TH ST, SUITE 2704, PHILADELPHIA, PA 19103-6231
(267) 908-6363
Mailing address
8532 TEMPLE RD, PHILADELPHIA, PA 19150-1909
(856) 524-8580
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
PS017234
PA
Other
Enumeration date
01/29/2017
Last updated
02/09/2017
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