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Individual

CLARA A LOGAN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
EDM

Contact information

Practice address
10I ROESSLER RD, WOBURN, MA 01801-6208
(781) 932-8114
Mailing address
70 OAK ST, WAKEFIELD, MA 01880-3833

Taxonomy

Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
12089
MA
101YM0800X
Mental Health Counselor

Other

Enumeration date
09/17/2018
Last updated
08/08/2022
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