Individual
MARY JANE KELLOGG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2117 E TYLER AVE, SUITE B, HARLINGEN, TX 78550-7211
(956) 440-0580
(956) 440-0584
Mailing address
2117 E TYLER AVE, SUITE B, HARLINGEN, TX 78550-7211
(956) 440-0580
(956) 440-0584
Taxonomy
Speciality
Code
Description
License number
State
2355S0801X
Speech-Language Assistant
Primary
33375
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
33375
STATE LICENSE
TX
Enumeration date
05/15/2009
Last updated
05/15/2009
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