Individual
LOGAN JAMES GILL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
6040 W LISBON AVE STE 103, MILWAUKEE, WI 53210-2116
(414) 442-1751
(414) 442-1775
Mailing address
1519 S 70TH ST, WEST ALLIS, WI 53214-4821
(608) 239-3483
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Enumeration date
07/20/2018
Last updated
07/20/2018
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