Provider Demographics
NPI:1386477545
Name:LEE, LOGAN (OTD, OTR/L)
Entity type:Individual
Prefix:DR
First Name:LOGAN
Middle Name:
Last Name:LEE
Suffix:
Gender:F
Credentials:OTD, OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3221 PEOPLES DR STE 110
Mailing Address - Street 2:
Mailing Address - City:HARRISONBURG
Mailing Address - State:VA
Mailing Address - Zip Code:22801-7622
Mailing Address - Country:US
Mailing Address - Phone:540-638-2478
Mailing Address - Fax:540-908-4801
Practice Address - Street 1:3221 PEOPLES DR STE 110
Practice Address - Street 2:
Practice Address - City:HARRISONBURG
Practice Address - State:VA
Practice Address - Zip Code:22801-7622
Practice Address - Country:US
Practice Address - Phone:540-638-2478
Practice Address - Fax:540-908-4801
Is Sole Proprietor?:No
Enumeration Date:2024-08-23
Last Update Date:2025-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0119010626225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist