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1083252092
LOGAN EDWARD WIEDEMAN
IRVINE, CA
NPI
1083252092
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
106S00000X Behavior Technician
Enumeration Date
2019-12-20
Last Update Date
2019-12-20
Business Address
LOGAN EDWARD WIEDEMAN
16782 VON KARMAN AVE STE 11
IRVINE, CA 92606-2417
Phone number: 949-833-2237
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Mailing Address
LOGAN EDWARD WIEDEMAN
16782 VON KARMAN AVE STE 11
IRVINE, CA 92606-2417
Phone number: 949-833-2237
Copy
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