Individual
CONNIE L KELLOGG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCMHC
Contact information
Practice address
231 CONCORD AVE, SUITE #3, ST JOHNSBURY, VT 05819-1513
(802) 748-9555
Mailing address
231 CONCORD AVE, SUITE #3, ST JOHNSBURY, VT 05819-1513
(802) 748-9555
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
068-0000761
VT
Other
Enumeration date
01/07/2009
Last updated
01/07/2009
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