Logan Waight

NPI 1174099725 · on the registry since 2018

Practice

Address: 1300 Hampton Ave Ste 200
Saint Louis, MO 63139
Phone: (314) 668-2804
Organisation at this address: Soulard Place Llc
Bethany Christian Services
Adella Consumer Directed Services, Llc
Inferred from a shared address, not stated in the registry.
Clinicians at this address: 25

Registry record

Primary taxonomy: 101YP2500X
101YP2500X
Licence states on file: MO
From the registry's licence fields, which are often incomplete.
Sex: Male
Record last updated: 2025-01-22

Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Missouri