Individual
MCKENNA LOGAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1063 MCGAW AVE STE 100, IRVINE, CA 92614-5554
(714) 834-1111
Mailing address
1063 MCGAW AVE STE 100, IRVINE, CA 92614-5554
(714) 834-1111
Taxonomy
Speciality
Code
Description
License number
State
106E00000X
Assistant Behavior Analyst
Primary
—
CA
106S00000X
Behavior Technician
—
—
Other
Enumeration date
03/06/2018
Last updated
10/23/2020
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