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Individual

STEFANIE ANN LOGUE

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
OTD OTRL

Contact information

Practice address
981 HIGH HOUSE RD, STE 100, CARY, NC 27513-3510
(919) 388-0111
(919) 388-8668
Mailing address
981 HIGH HOUSE RD, STE 100, CARY, NC 27513-3510
(919) 388-0111
(919) 388-8668

Taxonomy

Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
6367
NC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
145CU
BCBS OF NC
NC
05
7302007
NC
Enumeration date
05/31/2007
Last updated
08/29/2011
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