Individual
MS. TRACEY LOGAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
B.S.
Contact information
Practice address
744 SE 25TH ST, OKLAHOMA CITY, OK 73129-4843
(405) 636-1463
Mailing address
744 SE 25TH ST, OKLAHOMA CITY, OK 73129-4843
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
—
—
Other
Enumeration date
05/27/2010
Last updated
08/25/2011
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