Individual
MS. BREA A LOGAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
COTA/L
Contact information
Practice address
1455 LOUISIANA AVE, APT 4212, LEAGUE CITY, TX 77573-5710
(785) 554-3498
Mailing address
1455 LOUISIANA AVE, 4212, LEAGUE CITY, TX 77573-5710
(785) 554-3498
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
211601
TX
Other
Enumeration date
11/20/2012
Last updated
11/20/2012
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