Logan, Mary Callaway
Logan, Mary Callaway is an sole proprietor health care provider with primary practice located at 1200 Ponce De Leon Ave Ne , Atlanta GA 30306-4602. She recently has only one registered license in Behavioral Health & Social Service Providers / Pastoral, which is considered as her primary health care specialty. Logan, Mary Callaway can be contacted via phone (404) 931-6395.Contact Information
Primary practice address
1200 Ponce De Leon Ave Ne
Atlanta GA 30306-4602
Phone: (404) 931-6395
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Pastoral | 101YP1600X | 000758 | Georgia |
Profile Details
| NPI number | 1245440254 |
|---|---|
| LBN Legal business name | Logan, Mary Callaway |
| Credentials | LPC, M.DIV., FELLOW |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | May 22nd, 2007 |
| Last updated | Jul 8th, 2007 - about 18 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1245440254 | NPPES |
| Georgia | Other | 000758 | LICENSED PROFESSIONAL COU |
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