Individual
MISS JENNIFER JOY LOGAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COTA
Contact information
Practice address
6700 E 45TH ST N, BEL AIRE, KS 67226-8817
(316) 744-4109
Mailing address
159 LIOBA DR, ANDOVER, KS 67002-9764
(316) 259-0765
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
18-00737
KS
Other
Enumeration date
09/21/2010
Last updated
09/21/2010
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