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Individual

LOGAN C DUGINSKE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
SLP CF

Contact information

Practice address
11300 MONTGOMERY BLVD NE, ELDORADO HS, ALBUQUERQUE, NM 87111-2602
(505) 296-4871
Mailing address
11300 MONTGOMERY BLVD NE, ELDORADO HS, ALBUQUERQUE, NM 87111-2602
(505) 296-4871

Taxonomy

Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
C 5180
NM

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
NONE ASSIGNED
NM
Enumeration date
08/31/2012
Last updated
08/31/2012
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