Individual
LOGAN SULLIVAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
38 N SCOTT ST, CARBONDALE, PA 18407-1888
(570) 280-2800
Mailing address
38 N SCOTT ST, CARBONDALE, PA 18407-1888
(570) 280-2800
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
SL017079
PA
Other
Enumeration date
08/14/2023
Last updated
08/14/2023
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