Individual
SARA LOGAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
COTA/L
Contact information
Practice address
1002 JIB DR, APT. 206, ORLANDO, FL 32825-3151
(407) 765-1592
Mailing address
1002 JIB DR, APT. 206, ORLANDO, FL 32825-3151
(407) 765-1592
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
OTA 13776
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
L250790807680
DMV
FL
Enumeration date
11/13/2014
Last updated
11/13/2014
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