Individual
DR. JESSE THOMAS LOGAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LCMFT
Contact information
Practice address
8901 WISCONSIN AVE, BLDG. 19, 6504, BETHESDA, MD 20889-5600
(301) 400-1928
Mailing address
16070 A E MULLINIX RD, WOODBINE, MD 21797-8438
(410) 489-4398
Taxonomy
Speciality
Code
Description
License number
State
101YP1600X
Pastoral Counselor
LC2001
MD
106H00000X
Marriage & Family Therapist
Primary
LCM422
MD
Other
Enumeration date
12/20/2006
Last updated
10/28/2015
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