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Individual

MR. JAMES LOGAN SAMSEL

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
M.S. CF-SLP

Contact information

Practice address
3036 N BOLDT DR, FLAGSTAFF, AZ 86001-0960
(928) 773-0895
(928) 779-0896
Mailing address
613 N BEAVER ST, FLAGSTAFF, AZ 86001-3005
(928) 213-1419

Taxonomy

Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
TSLP5158
AZ

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
146879
AHCCCS#
AZ
Enumeration date
11/08/2006
Last updated
07/08/2007
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