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Organization

DEPARTMENT OF VETERAN AFFAIRS

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MS. ANNETTE LOGAN MSW (ADDICTION THERAPIST)
(203) 479-8066
Entity
Organization

Contact information

Practice address
950 CAMPBELL AVE, WEST HAVEN, CT 06516-2770
(203) 479-8066
(203) 479-8061
Mailing address
25 LAWNCREST RD, NEW HAVEN, CT 06515-1512
(203) 389-0292

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary

Other

Enumeration date
01/28/2009
Last updated
01/28/2009
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