Doctor Name: | ERIN M LOGAN |
NPI Number: | 1063852622 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | M.S. LPC |
License Number: | |
Business Practice Address: | 529 N Grand St Enid, OK - 737013216 |
Business Phone Number: | 5802348880 |
Business Fax Number: | 5802348891 |
Mailing Address: | 7908 Nw 23rd Street, BETHANY |
State: | OK |
Postal Code: | 730084950 |
Phone Number: | 7795372164 |
Fax Number: | |
NPI Enumeration Date: | 06/27/2013 |
NPI Last Update Date: | 05/23/2016 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YM0800X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Mental Health |
Taxonomy Definition: |