Individual
MR. BRENT LOGAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.A, RBT
Contact information
Practice address
3322 WILLIAM JOHNSTON LN APT 32, DUMFRIES, VA 22026-2163
(703) 434-0879
Mailing address
3322 WILLIAM JOHNSTON LN APT 32, DUMFRIES, VA 22026-2163
(703) 434-0879
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
BACB724383
VA
Other
Enumeration date
01/27/2022
Last updated
01/27/2022
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