Individual
JA'KEYA KELLOM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
707 W MILWAUKEE ST, DETROIT, MI 48202-2943
(313) 344-9099
Mailing address
24574 VALLEY AVE, EASTPOINTE, MI 48021-1052
(313) 231-9649
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
6401017522
MI
101YP2500X
Professional Counselor
Primary
6401222523
MI
Other
Enumeration date
07/22/2019
Last updated
04/28/2023
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