| NPI | 1598438095 |
|---|---|
| Former Name | LALAURA L LOGAN |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0808X Nurse Practitioner Psychiatric/Mental Health (Licence: IA G177211) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: IL 041387210) |
| Enumeration Date | 2021-07-29 |
| Last Update Date | 2023-12-28 |