Individual
LOGAN ROBERTSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
12708 RIATA VISTA CIR, AUSTIN, TX 78727-7167
(512) 795-2422
Mailing address
8316 COLUMBIA FALLS DR, ROUND ROCK, TX 78681-3546
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
212517
—
Other
Enumeration date
02/17/2018
Last updated
02/17/2018
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