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Individual

DUSTIN M LOGAN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PHD

Contact information

Practice address
8201 N MICHAELSON ST, PALMER, AK 99645-8196
(907) 745-5066
(877) 640-1413
Mailing address
PO BOX 3034, PALMER, AK 99645-3034
(907) 745-5066
(907) 746-2851

Taxonomy

Speciality
Code
Description
License number
State
103G00000X
Clinical Neuropsychologist
Primary
121536
AK
103TC0700X
Clinical Psychologist
60616291
WA

Other

Enumeration date
01/24/2008
Last updated
04/24/2024
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