Individual
LOGAN THOMAS GORDON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LAC
Contact information
Practice address
35401 MISSION DR, SAINT IGNATIUS, MT 59865-7791
(406) 745-3525
Mailing address
PO BOX 880, SAINT IGNATIUS, MT 59865-0880
(406) 745-3525
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
BBH-ACLC-LIC-37537
MT
Other
Enumeration date
09/08/2020
Last updated
04/22/2024
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