Most Relevant Information
Provider Data
| NPI Number: | 1003207259 |
| Provider Name: | DIANE LOGAN PHD, CSAC |
| Entity Type: | Individual |
| Taxonomy Code: | 101YA0400X |
| Specialty: | Counselor |
| License Number: | 2055-19 |
Most Important Dates
| Enumeration Date: | 02/10/2015 |
| Last Updated: | 03/15/2020 |
Provider Practice Location
75-5751 KUAKINI HWY STE 104
KAILUA KONA
HI
967401705
Practice Location Phone/Fax
| Phone: | 8083265629 |
| Fax: |
Provider Mailing Location
PO BOX 5488
KAILUA KONA
HI
967455488
Provider Mailing Phone/Fax
| Phone: | 8087855443 |
| Fax: |