Individual
LOGAN CORNELISON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LCSW
Contact information
Practice address
3601 THE VANDERBILT CLINIC, NASHVILLE, TN 37232-3095
(615) 322-5000
Mailing address
3841 GREEN HILLS VILLAGE DR STE 200, NASHVILLE, TN 37215-2691
(615) 322-6842
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
9087
TN
Other
Enumeration date
05/17/2024
Last updated
10/09/2024
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