Individual
ELLEN KELLOGG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.A.CCC-SLP
Contact information
Practice address
393 PALM COAST PKWY SW, PALM COAST, FL 32137-4773
(585) 202-2745
Mailing address
PO BOX 748, FLAGLER BEACH, FL 32136-0748
(585) 202-2745
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
SA10093
FL
Other
Enumeration date
09/21/2014
Last updated
09/21/2014
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