Individual
ANNETTE LOGAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1180 W MAHALO PL UNIT B, COMPTON, CA 90220-5443
(310) 868-5379
Mailing address
1180 W MAHALO PL UNIT B, COMPTON, CA 90220-5443
(310) 868-5379
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
—
—
172V00000X
Community Health Worker
Primary
—
—
Other
Enumeration date
10/01/2021
Last updated
07/22/2024
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