Logston, Shawn Marie

Logston, Shawn Marie is an individual health care provider with primary practice located at 602 Vonderburg Dr Suite 201, Brandon FL 33511-5900. She recently has 3 registered licenses in different health care specialties including Speech, Language and Hearing Service Providers / Speech-Language Pathologist, Speech, Language and Hearing Service Providers / Speech-Language Assistant, Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Developmental Therapist. Speech, Language and Hearing Service Providers / Speech-Language Pathologist is her primary health care specialty. Logston, Shawn Marie can be contacted via phone (813) 653-1149.

Contact Information

Primary practice address
602 Vonderburg Dr Suite 201 Brandon FL 33511-5900
Phone: (813) 653-1149
Fax: (813) 654-6644
Website:
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Health care specialties

SpecialtyCodeLicense #State
Speech, Language and Hearing Service Providers / Speech-Language Pathologist 235Z00000X SA11849 Florida
Speech, Language and Hearing Service Providers / Speech-Language Assistant 2355S0801X SI1960 Florida
Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Developmental Therapist 222Q00000X SA11849 Florida

Profile Details

NPI number 1871888107
LBN Legal business name Logston, Shawn Marie
Credentials
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 15th, 2011
Last updated Mar 19th, 2013 - about 12 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1871888107 NPPES
Florida MEDICAID 004084700
Florida MEDICAID 008214600

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