Individual
EMILY LOGAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
106 MOUNT VISTA RD, DENTON, NC 27239-8793
(336) 859-2181
Mailing address
557 EASTSIDE DR, DENTON, NC 27239-7639
(336) 590-3904
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
11008
NC
Other
Enumeration date
07/21/2017
Last updated
03/08/2023
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