Individual
LOGAN HERNDON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTD, OTR/L
Contact information
Practice address
1535 N MOUNT JULIET RD, MT JULIET, TN 37122-3315
(615) 560-6622
Mailing address
5130 STALLWORTH DR, NASHVILLE, TN 37220-2049
(704) 201-1185
Taxonomy
Speciality
Code
Description
License number
State
225XP0200X
Pediatric Occupational Therapist
Primary
6543
TN
Other
Enumeration date
04/06/2022
Last updated
04/06/2022
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