Individual
MS. DELLA LOGSDON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PRSS
Contact information
Practice address
2 WICKERSHAM ST, MANGUM, OK 73554-9117
(580) 782-3337
Mailing address
PO BOX 376, GRANITE, OK 73547-0376
(580) 301-4060
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
904207
OK
Other
Enumeration date
12/03/2009
Last updated
12/03/2009
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