LOGAN DETWEILER

TAMPA, FL
NPI1417411984
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy225X00000X Occupational Therapist
(Licence: FL  21128)
Additional Taxonomies106S00000X Behavior Technician
Enumeration Date2019-01-29
Last Update Date2020-08-24
Business Address
LOGAN DETWEILER
3217 S MACDILL AVE
TAMPA, FL 33629-1719
Phone number: 813-284-7941
Mailing Address
LOGAN DETWEILER
1321 MURFREESBORO PIKE STE 702
NASHVILLE, TN 37217-2679
Phone number: 615-724-4722