Individual
JESSE LOGUE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.S.
Contact information
Practice address
12650 HAMILTON CROSSING BLVD, CARMEL, IN 46032-5400
(317) 249-2242
(442) 896-7988
Mailing address
2931 E BIDDLE ST, BALTIMORE, MD 21213-3939
(443) 923-1886
(443) 923-1895
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
1-14-17462
IN
103T00000X
Psychologist
Primary
—
—
103TC0700X
Clinical Psychologist
20043337B
IN
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
07/15/2014
Last updated
03/26/2025
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