person
Etienne Fox Logan II
Addiction (Substance Use Disorder) Counselor in Suffolk, Virginia
NPI 1346712478

Etienne Fox Logan II is an Addiction (Substance Use Disorder) Counselor based in Greenville, VA and is specialized in Addiction (Substance Use Disorder). Etienne Fox Logan II practices in Suffolk, VA. The NPI Number for Etienne Fox Logan II is 1346712478 and holds a License No. 0732005011 (Virginia).

The current practice location address for Etienne Fox Logan II is 1258 Holland Rd, Suffolk, VA and can be reached out via phone at 757-809-4771 and via fax at 757-809-4932.

Location: 1258 Holland Rd, Suffolk, VA, 29601-2191
person
Provider Profile Details
NPI Number
1346712478
Provider Name
Etienne Fox Logan II
Credential
Provider Entity Type
Individual
Gender
Male
Address
1258 Holland Rd, Suffolk, VA, 29601-2191
Phone Number
757-809-4771
Fax Number
757-809-4932
Provider Enumeration Date
12/31/2018
Last Update Date
03/10/2024
institution
Provider Business Practice Location Address Details
Address
1258 Holland Rd
City
State
Zip
23434-6313
Phone Number
757-809-4771
Fax Number
757-809-4932
person
Provider Business Mailing Address Details
Address
1258 Holland Rd
City
State
Zip
23434-6313
Phone Number
757-809-4771
Fax Number
757-809-4932
person
Provider's Taxonomy Details 1
Type
Behavioral Health & Social Service Providers
Classification
Counselor
Speciality
Addiction (Substance Use Disorder)
Taxonomy
License No.
0732005011 (Virginia)
Definition
Definition to come...
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