Individual
LOGAN KEVIN EVERETT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MA, LMFT
Contact information
Practice address
7425 E 86TH ST, INDIANAPOLIS, IN 46256-1207
(317) 474-6448
Mailing address
9493 MAPLELEAF CIR, FISHERS, IN 46038-8524
(765) 401-0921
Taxonomy
Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
Primary
35001943A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
47-1561586
N/A
IN
Enumeration date
08/11/2014
Last updated
11/02/2016
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