Individual
AVALLA LOGAN RICHESON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
531 N 28TH ST, LAFAYETTE, IN 47904-2844
(765) 761-8902
Mailing address
531 N 28TH ST, LAFAYETTE, IN 47904-2844
(765) 761-8902
(765) 761-8902
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
04/01/2026
Last updated
04/01/2026
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