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General NPI Number Information
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NPI Number | 1699648022
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Entity Type | Individual
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Provider Name | FARRAH LOGAN
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Gender | Female
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Dates
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Enumeration Date | 09/23/2025
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Last Update Date | 09/23/2025
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Provider Practice Location Address
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Address Line | 835 LOUISA ST STE 205
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City | LANSING
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State | MI
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Zip | 48911-5200
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Country | US
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Telephone | 313-497-2665
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Fax | 313-583-7002
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Provider Business Mailing Address
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Address Line | 213 S DEAN ST
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City | BAY CITY
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State | MI
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Zip | 48706-4645
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Country | US
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Telephone | 989-295-2908
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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 | 106S00000X
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Taxonomy Name | Behavior Technician
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License Number |
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License Number State |
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