Individual
LOGAN A GABRIELSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTR/L
Contact information
Practice address
522 6TH BAXTER XING STE B, FORT MILL, SC 29708-6613
(803) 929-7408
(888) 711-0441
Mailing address
10 S 9TH ST, STE 4, NOBLESVILLE, IN 46060-2631
(765) 524-3946
(317) 708-6496
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
4399
MA
225X00000X
Occupational Therapist
Primary
5913
SC
Other
Enumeration date
05/16/2019
Last updated
11/24/2020
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