Individual
JORDON KYLE KELLAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LPC
Contact information
Practice address
36086 LANKFORD HWY, BELLE HAVEN, VA 23306
(757) 678-6580
Mailing address
PO BOX 591, EXMORE, VA 23350-0591
(757) 678-6580
(757) 578-8231
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
0701010801
VA
Other
Enumeration date
10/21/2021
Last updated
10/21/2021
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