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Individual

JAMES R LOGAN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PHD, MP

Contact information

Practice address
41 LORD OF LORDS AVE, PINEVILLE, LA 71360-2113
(318) 641-0444
Mailing address
1927 WHITE ST, ALEXANDRIA, LA 71301-6357
(318) 613-9981

Taxonomy

Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
702
LA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1146579
LA
Enumeration date
07/07/2006
Last updated
07/08/2007
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