Individual
MRS. LAURA MARIE LOGAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COTA/L
Contact information
Practice address
2701 MAGNOLIA SPRINGS DR, LEXINGTON, KY 40511-1198
(859) 410-6575
Mailing address
124 DALTON RD, GEORGETOWN, KY 40324-8005
(859) 267-3473
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
265950
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
265950
KY LICENSE
KY
Enumeration date
06/22/2021
Last updated
06/22/2021
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