Individual
MS. LOGAN DENISE LUKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTR/L
Contact information
Practice address
12191 CLIPPER DR, LAKE RIDGE, VA 22192-2237
(703) 457-8648
Mailing address
10800 OLD SAINT AUGUSTINE RD APT 106, JACKSONVILLE, FL 32257-1021
(904) 502-1889
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
0119-009690
VA
Other
Enumeration date
10/13/2022
Last updated
10/13/2022
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