Individual
KENDON ELLERMAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
108 VICTORIA DR, HATTIESBURG, MS 39402-3439
(228) 861-8870
Mailing address
108 VICTORIA DR, HATTIESBURG, MS 39402-3439
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
C7432
MS
Other
Enumeration date
10/10/2025
Last updated
10/10/2025
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