Individual
MADISON LOGAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3482 MCCLURE AVE, SUITE 150, WEST LAFAYETTE, IN 47906-4164
(765) 828-3547
(844) 562-0079
Mailing address
3482 MCCLURE AVE, SUITE 150, WEST LAFAYETTE, IN 47906-4164
(765) 828-3547
(844) 562-0079
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
46003077A
IN
Other
Enumeration date
09/29/2016
Last updated
09/29/2016
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