Provider Demographics
NPI:1942692074
Name:LOGAN, BONNIE L (MSW)
Entity Type:Individual
Prefix:
First Name:BONNIE
Middle Name:L
Last Name:LOGAN
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1404 RACE ST
Mailing Address - Street 2:SUITE 302
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45202-7297
Mailing Address - Country:US
Mailing Address - Phone:859-991-2846
Mailing Address - Fax:
Practice Address - Street 1:1404 RACE ST
Practice Address - Street 2:SUITE 302
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45202-7297
Practice Address - Country:US
Practice Address - Phone:859-991-2846
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-02-26
Last Update Date:2015-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker