Doctor Name: | JANELLE BREANNE LOGAN |
NPI Number: | 1336597814 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | |
License Number: | SZ7528 |
Business Practice Address: | 169 Tequesta Dr 24e Tequesta, FL - 334692768 |
Business Phone Number: | 5617478188 |
Business Fax Number: | |
Mailing Address: | 936 Dolphin Dr, JUPITER |
State: | FL |
Postal Code: | 334584302 |
Phone Number: | 5614278772 |
Fax Number: | |
NPI Enumeration Date: | 05/25/2016 |
NPI Last Update Date: | 05/25/2016 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 235Z00000X |
License Number: | SZ7528 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | FL |
Taxonomy Type: | Speech, Language and Hearing Service Providers |
Taxonomy Classification: | Speech-Language Pathologist |
Taxonomy Specialization: | |
Taxonomy Definition: | A speech pathologist is a person qualified by a master |