| NPI | 1124747506 |
|---|---|
| Former Name | DEBORA LOGAN |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 171M00000X Case Manager/Care Coordinator |
| Additional Taxonomies | 174400000X Specialist |
| Enumeration Date | 2022-08-26 |
| Last Update Date | 2022-08-26 |