Provider Demographics
NPI:1366336026
Name:ALLEY, LOGAN KATHLEEN (SLP)
Entity type:Individual
Prefix:
First Name:LOGAN
Middle Name:KATHLEEN
Last Name:ALLEY
Suffix:
Gender:X
Credentials:SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4819 WALDEN LN STE 4880
Mailing Address - Street 2:
Mailing Address - City:LANHAM
Mailing Address - State:MD
Mailing Address - Zip Code:20706-4826
Mailing Address - Country:US
Mailing Address - Phone:240-667-1423
Mailing Address - Fax:240-667-1423
Practice Address - Street 1:4819 WALDEN LN STE 4880
Practice Address - Street 2:
Practice Address - City:LANHAM
Practice Address - State:MD
Practice Address - Zip Code:20706-4826
Practice Address - Country:US
Practice Address - Phone:240-667-1423
Practice Address - Fax:240-667-1423
Is Sole Proprietor?:No
Enumeration Date:2025-06-06
Last Update Date:2025-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD11567235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist