Individual
MARY LUCY KELLOGG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CCC-SLP
Contact information
Practice address
490 MIRASOL DR, LOVELAND, CO 80537-2339
(970) 342-2400
Mailing address
490 MIRASOL DR, LOVELAND, CO 80537-2339
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
SLP.0001925
CO
Other
Enumeration date
05/05/2016
Last updated
05/05/2016
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