Individual
SAMUEL KELLOGG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LICSW
Contact information
Practice address
25 WELLMAN AVE, NORTH CHELMSFORD, MA 01863-1334
(978) 251-4050
Mailing address
200 SWANTON ST APT 320, WINCHESTER, MA 01890-4316
Taxonomy
Speciality
Code
Description
License number
State
1041S0200X
School Social Worker
Primary
121488
MA
Other
Enumeration date
10/08/2018
Last updated
10/08/2018
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