Individual
DR. MARVIN LEROY LOGEL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PH.D.
Contact information
Practice address
5200 WILLSON RD STE 150, EDINA, MN 55424-1300
(952) 221-7166
(952) 937-0925
Mailing address
301 ALTARA AVE APT 519, CORAL GABLES, FL 33146-1465
(952) 221-7166
(952) 937-0925
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
LP0569
MN
103T00000X
Psychologist
PY7902
FL
103TC0700X
Clinical Psychologist
Primary
LP0569
MN
103TC0700X
Clinical Psychologist
PY7902
FL
103TP0814X
Psychoanalysis Psychologist
LP0569
MN
103TP0814X
Psychoanalysis Psychologist
PY7902
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
10076LO
BLUE-CROSS BLUE-SHIELD
MN
Enumeration date
03/22/2007
Last updated
01/12/2025
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