Provider Demographics
NPI:1235394818
Name:LOGAN, JANET LYNN (MS CCC-SLP)
Entity Type:Individual
Prefix:MRS
First Name:JANET
Middle Name:LYNN
Last Name:LOGAN
Suffix:
Gender:F
Credentials:MS CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1165 7TH ST
Mailing Address - Street 2:
Mailing Address - City:BEAVER
Mailing Address - State:PA
Mailing Address - Zip Code:15009-1819
Mailing Address - Country:US
Mailing Address - Phone:724-775-4326
Mailing Address - Fax:
Practice Address - Street 1:1165 7TH ST
Practice Address - Street 2:
Practice Address - City:BEAVER
Practice Address - State:PA
Practice Address - Zip Code:15009-1819
Practice Address - Country:US
Practice Address - Phone:724-775-4326
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-07-23
Last Update Date:2008-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASL006222L235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist