Blackmon, Logan

Blackmon, Logan is an individual health care provider with primary practice located at 1711 Destiny Ln Ste 107 , Bowling Green KY 42104-1067. He recently has only one registered license in Behavioral Health & Social Service Providers / Behavior Technician, which is considered as his primary health care specialty. Blackmon, Logan can be contacted via phone (270) 702-2464.

Contact Information

Primary practice address
1711 Destiny Ln Ste 107 Bowling Green KY 42104-1067
Phone: (270) 702-2464
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Behavior Technician 106S00000X

Profile Details

NPI number 1245886563
LBN Legal business name Blackmon, Logan
Credentials
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 13th, 2019
Last updated Aug 13th, 2019 - about 6 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.

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