Healthcare Provider Details

I. General information

NPI: 1871000935
Provider Name (Legal Business Name): LOGAN SPAUGY
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/10/2018
Last Update Date: 06/24/2026
Certification Date: 06/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

439 BENNERT DR
VANDALIA OH
45377-2507
US

IV. Provider business mailing address

1985 W HENDERSON PMB 60639
COLUMBUS OH
43220
US

V. Phone/Fax

Practice location:
  • Phone: 937-280-5173
  • Fax: 937-280-5174
Mailing address:
  • Phone: 937-280-5173
  • Fax: 937-280-5174

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: