Individual
MS. LILLIE MAE LOGGINS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COTA
Contact information
Practice address
210 WEST AVE, LEVELLAND, TX 79336-3233
(806) 894-5053
Mailing address
5518 35TH ST, LUBBOCK, TX 79407-4002
(806) 787-9879
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
20877
TX
Other
Enumeration date
09/10/2018
Last updated
09/10/2018
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