Individual
MRS. SANDRA L LOGAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MA MED LPC
Contact information
Practice address
1801 E 5TH STREET, SUITE 203, CHARLOTTE, NC 28204
(704) 373-9444
Mailing address
1801 E 5TH STREET, SUITE 204, CHARLOTTE, NC 28204
(704) 375-3545
(704) 375-3632
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
4715
NC
Other
Enumeration date
12/28/2006
Last updated
07/08/2007
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