Individual
MRS. JACQUELYN MARIE KELLOGG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.S., CCC-SLP
Contact information
Practice address
5465 ROUTE 8, GIBSONIA, PA 15044-9696
(724) 444-5333
(724) 444-5335
Mailing address
2977 CHAUTAUQUA DR, GIBSONIA, PA 15044-8228
(724) 816-2129
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
SL008157
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
101360361
—
PA
Enumeration date
02/28/2007
Last updated
06/16/2009
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