Individual
CARLIE ALEXANDRA KELLOGG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
212 VERNON ST, EMINENCE, KY 40019-1441
(502) 889-1015
Mailing address
212 VERNON ST, EMINENCE, KY 40019-1441
(502) 889-1015
Taxonomy
Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
Primary
259937
KY
Other
Enumeration date
01/18/2022
Last updated
01/18/2022
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