Etienne Fox Logan II
Etienne Fox Logan II is an Addiction (Substance Use Disorder) Counselor in Suffolk, Virginia. Licensed in Virginia. Registered with an NPI since 2018.
- Licensed in
- VA
- In the registry since
- 2018
Practice location Address checks out
1258 Holland RdSuffolk, VA 23434-6313
Phone: (757) 809-4771
Fax: (757) 809-4932
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Pin is approximate — placed at the ZIP-code centre, not the exact door.
Specialties & licences
| Addiction (Substance Use Disorder) Counselor (primary) | Taxonomy 101YA0400X · Licence 0732005011 (VA) |
|---|
Record details
| NPI number | 1346712478 |
|---|---|
| Entity type | Individual (Type 1) |
| Gender | Male |
| Sole proprietor | No |
| NPI enumerated | December 31, 2018 |
| Last updated in NPPES | December 31, 2018 |
| Mailing address | 55 Beattie Pl Ste 810, Greenville, SC 29601-2191 |
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Mrs. Norashawnda Miller, CSAC-A, ICADC
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Antoinette L Porter
1258 Holland Rd, Suffolk, VA 23434-6313 · (757) 409-4771