Individual
BARBARA KELLOGG GANNON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PSY.D.
Contact information
Practice address
30 WESTERN AVE STE 209, GLOUCESTER, MA 01930-3664
(978) 290-2539
Mailing address
30 WESTERN AVE STE 209, GLOUCESTER, MA 01930-3664
(978) 290-2539
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
7950-PY-PR
MA
Other
Enumeration date
08/03/2020
Last updated
08/03/2020
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