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Individual

NICOLE RENEE LOGAN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
LPC

Contact information

Practice address
887 JOHNNIE DODDS BLVD STE 217, MOUNT PLEASANT, SC 29464-3154
(843) 593-2274
Mailing address
1823 BASILDON RD, MOUNT PLEASANT, SC 29466-7140
(843) 593-2274

Taxonomy

Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
6488
SC

Other

Enumeration date
04/20/2017
Last updated
04/20/2017
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