Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 104100000X | Social Worker |
NPI | 1003457870 |
---|---|
Provider Name | Logan Hewitt |
First Address | Hyattsville, MD 20782-1705 |
Second Address | Rockville, MD 20850-3357 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 03/10/2019 |
Last Update Date | 24/11/2021 |