Individual
MARQUITA KELLOGG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
1701 HARDEE AVE SW, ATLANTA, GA 30310-5110
(000) 000-0000
Mailing address
4812 HILLSIDE CT, POWDER SPRINGS, GA 30127-3893
(678) 382-5768
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
CSW007297
GA
Other
Enumeration date
11/20/2023
Last updated
11/20/2023
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