Individual
MR. LOGAN DOUGLASS WAGNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LSW
Contact information
Practice address
1700 E BRADFORD PIKE, MARION, IN 46952-8643
(765) 664-7740
Mailing address
1700 E BRADFORD PIKE, MARION, IN 46952-8643
(765) 664-7740
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
99133854A
IN
Other
Enumeration date
03/18/2026
Last updated
03/18/2026
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