Individual
MS. GLENDA KAYE KELLOGG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
4523 W BELLVIEW DR, COLUMBIA, MO 65203-0530
(573) 823-9783
Mailing address
4523 W BELLVIEW DR, COLUMBIA, MO 65203-0530
(573) 823-9783
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
003460
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
496845934
—
MO
Enumeration date
06/01/2006
Last updated
10/14/2011
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