=====================================================
General NPI Number Information
=====================================================
NPI Number | 1477478030
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | MARGARETHA GERTRUIDA LOGUE OTR/L
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 08/12/2026
-----------------------------------------------------
Last Update Date | 08/12/2026
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 7320 N PALMYRA RD
-----------------------------------------------------
City | CANFIELD
-----------------------------------------------------
State | OH
-----------------------------------------------------
Zip | 44406-9709
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 330-533-8755
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 630 N KEEL RIDGE RD
-----------------------------------------------------
City | HERMITAGE
-----------------------------------------------------
State | PA
-----------------------------------------------------
Zip | 16148-3150
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 724-977-5619
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 225X00000X
-----------------------------------------------------
Taxonomy Name | Occupational Therapist
-----------------------------------------------------
License Number | OT009438
-----------------------------------------------------
License Number State | OH
-----------------------------------------------------