Individual
NICOLE LOGAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCPC
Contact information
Practice address
5301 BUCKEYSTOWN PIKE STE 170, FREDERICK, MD 21704-8380
(240) 575-9688
Mailing address
1003 W 7TH ST STE 403, FREDERICK, MD 21701-8532
(443) 918-7108
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
LC13775
MD
101YM0800X
Mental Health Counselor
LGP11490
MD
Other
Enumeration date
07/02/2021
Last updated
08/09/2023
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