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General NPI Number Information
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NPI Number | 1104584200
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Entity Type | Individual
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Provider Name | LOGAN N HUBBARD LMFT
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Gender | Female
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Dates
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Enumeration Date | 12/06/2021
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Last Update Date | 02/04/2026
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Provider Practice Location Address
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Address Line | 3556 S 5600 W # 557
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City | SALT LAKE CITY
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State | UT
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Zip | 84120-2815
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Country | US
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Telephone | 615-669-0089
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Fax |
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Provider Business Mailing Address
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Address Line | 3556 S 5600 W # 557
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City | SALT LAKE CITY
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State | UT
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Zip | 84120-2815
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Country | US
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Telephone | 615-669-0089
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | 1853
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License Number State | TN
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Taxonomy #2
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | 14269230-3902
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License Number State | UT
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