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Individual

MISS STEPHANIE LOGAN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
515 W GREENDALE, DETROIT, MI 48203-4516
(586) 335-9755
Mailing address
515 W GREENDALE, DETROIT, MI 48203-4516
(586) 335-9755

Taxonomy

Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
MI
247200000X
Other Technician
Primary

Other

Enumeration date
09/06/2016
Last updated
04/02/2026
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