| Doctor Name: | PRISCILLA LOGAN |
| NPI Number: | 1124418785 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | PT |
| License Number: | T04757 |
| Business Practice Address: | 1 Landrum Ct Apt 303 Parkville, MD - 212341754 |
| Business Phone Number: | 4104261855 |
| Business Fax Number: | |
| Mailing Address: | 1 Landrum Ct, Apt 303 PARKVILLE |
| State: | MD |
| Postal Code: | 212341754 |
| Phone Number: | 4104261855 |
| Fax Number: | |
| NPI Enumeration Date: | 02/03/2015 |
| NPI Last Update Date: | 02/03/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 183700000X |
| License Number: | T04757 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | MD |
| Taxonomy Type: | Pharmacy Service Providers |
| Taxonomy Classification: | Pharmacy Technician |
| Taxonomy Specialization: | |
| Taxonomy Definition: | A person who works under the direct supervision of a licensed pharmacist and performs many pharmacy-related functions that do not require the professional judgment of a pharmacist. |