Individual
LOGAN LEA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
RBT
Contact information
Practice address
500 ALA MOANA BLVD STE 7-400, HONOLULU, HI 96813-4902
(808) 354-0090
Mailing address
4790 E ELUA WAY APT B, EWA BEACH, HI 96706-3054
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
RBT-17-43616
HI
Other
Enumeration date
11/03/2017
Last updated
11/03/2017
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