Individual
DR. SALLY J LOGERQUIST
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PH.D.
Contact information
Practice address
4602 W SWEETWATER AVE, GLENDALE, AZ 85304-1505
(602) 896-6513
(602) 896-6520
Mailing address
PO BOX 4673, SCOTTSDALE, AZ 85261-4673
(602) 896-6513
(602) 896-6520
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
3412
AZ
Other
Enumeration date
03/07/2007
Last updated
07/08/2007
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