Healthcare Provider Details

I. General information

NPI: 1619881166
Provider Name (Legal Business Name): LOGAN MCKENNA SALANGER
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/01/2026
Last Update Date: 10/01/2026
Certification Date: 10/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4881 NW 8TH AVE STE 1
GAINESVILLE FL
32605-4582
US

IV. Provider business mailing address

18021 DOUGLASS ST UNIT 1
HIGH SPRINGS FL
32643-9002
US

V. Phone/Fax

Practice location:
  • Phone: 352-474-8882
  • Fax:
Mailing address:
  • Phone: 315-706-9521
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License NumberIMT4746
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: