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Individual

MR. DANNY KELLUM

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
LPC

Contact information

Practice address
2722 E OAKLAND AVE, JOHNSON CITY, TN 37601-1844
(423) 967-9208
Mailing address
PO BOX 4721, JOHNSON CITY, TN 37602-4721
(423) 967-9208

Taxonomy

Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
0701003303
VA
101YP2500X
Professional Counselor
Primary
LPC0000001652
TN

Other

Enumeration date
04/23/2008
Last updated
04/23/2008
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