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1871251678
DESTINEE LOGAN
GRAPEVINE, TX
NPI
1871251678
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
225X00000X Occupational Therapist
(Licence: TX 122225)
Enumeration Date
2021-11-30
Last Update Date
2021-11-30
Business Address
DESTINEE LOGAN OTD, OTR
1643 LANCASTER DR STE 100
GRAPEVINE, TX 76051-3593
Phone number: 817-329-2524
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Mailing Address
DESTINEE LOGAN OTD, OTR
2800 BRAZOS BLVD APT 12314
EULESS, TX 76039-5446
Phone number:
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