Individual
ALLYSON KELLOGG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
912 S WASHINGTON ST, OWOSSO, MI 48867-4447
(989) 217-8061
Mailing address
PO BOX 663, LAKELAND, MI 48143-0663
(810) 559-2129
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
08/20/2020
Last updated
08/20/2020
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