National Provider Identifier

Jessica M. Logan, M.S., CCC-SLP, TSLD

Jessica M. Logan, M.S., CCC-SLP, TSLD is listed in the NPPES registry with a primary specialty of Speech-Language Pathologist in North Chili, NY and a listed phone number of (585) 208-2192.

NPI 1306179742North Chili, NYSpeech-Language Pathologist

Profile Overview

NPI
1306179742
Provider Type
Individual
Primary Specialty
Speech-Language Pathologist
Enumeration Date
September 17, 2009
Last Updated
January 26, 2016

Practice Location

  • 3 Springbrook Dr
  • North Chili, NY 14514-1220

Phone: (585) 208-2192

Specialties

  • Speech-Language Pathologist (235Z00000X)
Full Record
NPI
1306179742
Entity Type
Individual
Last Name
Logan
First Name
Jessica
Middle Name
M.
Credential
M.S., CCC-SLP, TSLD
Mailing Street Address
3 Springbrook Dr
Mailing City
North Chili
Mailing State
NY
Mailing ZIP Code
14514-1220
Mailing Country
US
Mailing Phone
(585) 208-2192
Practice Street Address
3 Springbrook Dr
Practice City
North Chili
Practice State
NY
Practice ZIP Code
14514-1220
Practice Country
US
Practice Phone
(585) 208-2192
Enumeration Date
September 17, 2009
Last Updated
January 26, 2016
Sex
Female
Sole Proprietor
No
updated_by_file
npidata_pfile_20050523-20260308.csv
Taxonomies
Speech-Language Pathologist (235Z00000X)
Other Identifiers
30-0213081 (NY, Tax Id)