Individual
LOGAN A DEBEATHAM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MS, OTR/L
Contact information
Practice address
1331 H ST NW STE 200, WASHINGTON, DC 20005-4706
(860) 983-1121
Mailing address
3401 E WEST HWY APT 329, HYATTSVILLE, MD 20782-2368
(860) 983-1121
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
10155
MD
225X00000X
Occupational Therapist
Primary
OT210002228
DC
Other
Enumeration date
02/07/2024
Last updated
02/07/2024
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