Logan Small

NPI #1043882749 in Capitola, California

Provider Information

NPI Number: 1043882749
Entity Type: Individual
Name: Logan Small
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Behavior Technician
Enumeration Date: Jul 13, 2021
Last Updated: Jul 13, 2021

Practice Location

Address: 2121 41ST AVE
City: Capitola
State: California
ZIP Code: 95010-2056
Phone: (303) 989-8169

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Behavior Technician	106S00000X	Primary

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