Individual
MR. LARRY RONALD KELLOGG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MSW, LCSW
Contact information
Practice address
1061 HARMON AVENUE, FORT STEWART, GA 31314-5674
(912) 315-6500
Mailing address
19 E 64TH ST, SAVANNAH, GA 31405-5201
(912) 272-9545
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
000738
GA
Other
Enumeration date
10/27/2009
Last updated
10/27/2009
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