Individual
SHERRY LYNN LOGAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OTR/L
Contact information
Practice address
100 BREWSTER BLVD, NAVAL HOSPITAL, CAMP LEJEUNE, NC 28547-2538
(910) 450-4159
(910) 450-4194
Mailing address
238 RED CARNATION DR, HOLLY RIDGE, NC 28445-7942
(910) 431-1032
(910) 431-1032
Taxonomy
Speciality
Code
Description
License number
State
225XP0200X
Pediatric Occupational Therapist
7388
NC
2865M2000X
Military General Acute Care Hospital
Primary
7388
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7302241
—
NC
01
—
7388
OT LICENSE
NC
Enumeration date
02/07/2010
Last updated
12/20/2013
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