Individual
ELLEN LOGAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CTRS, TRS
Contact information
Practice address
266 LEFT FORK HOBBLE CREEK CANYON RD, SPRINGVILLE, UT 84663
(385) 500-3529
Mailing address
5500 MING AVE STE 265, BAKERSFIELD, CA 93309-4696
Taxonomy
Speciality
Code
Description
License number
State
225800000X
Recreation Therapist
Primary
12454141-4002
UT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
12454141-4002
LICENSE
UT
Enumeration date
01/24/2025
Last updated
05/01/2025
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