Organization
JACQUELYN KELLOGG, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JACQUELYN KAY KELLOGG MA, LLP (PSYCHOLOGIST)
(616) 340-1061
Entity
Organization
Contact information
Practice address
6018 CORNERSTONE CT SW, GRANDVILLE, MI 49418
(616) 340-1061
Mailing address
6018 CORNERSTONE CT SW, GRANDVILLE, MI 49418
(616) 340-1061
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
—
—
Other
Enumeration date
02/06/2023
Last updated
02/06/2023
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