ETIENNE FOX LOGAN NPI 1346712478

NPI Information

NPI: 1346712478
Provider Name: ETIENNE FOX LOGAN
Classification: Counselor - 101YA0400X
Entity Type: Individual

Specialization: Addiction (Substance Use Disorder)

Address:
1258 HOLLAND RD
SUFFOLK, VA
ZIP 23434
Phone: (757) 809-4771
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Etienne Fox Logan is an addiction (substance use disorder) counselor in Suffolk, VA. Etienne Fox Logan NPI is 1346712478. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

1258 HOLLAND RD
SUFFOLK, VA
ZIP 23434-313
Phone: (757) 809-4771
Fax: (757) 809-4932

The enumeration date for this NPI number is 12/31/2018 and was last updated on 12/31/2018.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	101YA0400X	Counselor	Addiction (Substance Use Disorder)	0732005011	VIRGINIA	Yes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

NPI Synchronization or Removal

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