Individual
DAMIEN DIABLO KELLAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.A., LPC, PHD ABD
Contact information
Practice address
2220 LAKE HARBIN RD, MORROW, GA 30260-1907
(404) 337-0305
Mailing address
PO BOX 1871, STOCKBRIDGE, GA 30281-8871
(404) 337-0305
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
—
GA
101YP2500X
Professional Counselor
Primary
—
—
Other
Enumeration date
11/26/2007
Last updated
04/01/2013
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