Provider Demographics
NPI:1962210278
Name:SWAIN, LOGYN MICHELLE (CF-SLP)
Entity type:Individual
Prefix:
First Name:LOGYN
Middle Name:MICHELLE
Last Name:SWAIN
Suffix:
Gender:F
Credentials:CF-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4828 CYPRESS WOODS DR APT 275
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32811-3506
Mailing Address - Country:US
Mailing Address - Phone:954-789-6648
Mailing Address - Fax:
Practice Address - Street 1:1131 MINNESOTA AVE
Practice Address - Street 2:
Practice Address - City:WINTER PARK
Practice Address - State:FL
Practice Address - Zip Code:32789-4902
Practice Address - Country:US
Practice Address - Phone:407-303-1575
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-12-19
Last Update Date:2024-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSZ12439235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist