| Doctor Name: | JAMILAH Q LOGAN |
| NPI Number: | 1023200581 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | PH.D. |
| License Number: | |
| Business Practice Address: | 9261 W Van Buren St Tolleson, AZ - 853532941 |
| Business Phone Number: | 6235333901 |
| Business Fax Number: | 6235333902 |
| Mailing Address: | 6612 W Monroe St, PHOENIX |
| State: | AZ |
| Postal Code: | 850435065 |
| Phone Number: | 8505288525 |
| Fax Number: | |
| NPI Enumeration Date: | 08/17/2007 |
| NPI Last Update Date: | 08/17/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 103TS0200X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Psychologist |
| Taxonomy Specialization: | School |
| Taxonomy Definition: | |