Individual
LOGAN HUNTER REVALEE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1907 BUENA VISTA DR SE TRLR 37, ALBUQUERQUE, NM 87106-4146
(505) 285-0868
Mailing address
1907 BUENA VISTA DR SE TRLR 37, ALBUQUERQUE, NM 87106-4146
(505) 285-0868
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
07/30/2026
Last updated
07/30/2026
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