Individual
TIFFANY LOGAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
COTA
Contact information
Practice address
1428 CRAB APPLE LN, HARTSVILLE, SC 29550-8258
(184) 343-2679
Mailing address
1428 CRAB APPLE LN, HARTSVILLE, SC 29550-8258
(184) 343-2679
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
5108
SC
Other
Enumeration date
12/07/2022
Last updated
12/07/2022
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