Individual
HEATHER LOUISE LOGUE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COTA/L
Contact information
Practice address
13101 HARTFIELD AVE, SAN DIEGO, CA 92130-1511
(858) 336-9296
Mailing address
13101 HARTFIELD AVE, SAN DIEGO, CA 92130-1511
(858) 336-9296
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
4621
CA
Other
Enumeration date
09/07/2022
Last updated
09/07/2022
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