Individual
JACQUELYN KAY KELLOGG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MA, LLP
Contact information
Practice address
6018 CORNERSTONE CT SW, GRANDVILLE, MI 49418-3314
(616) 340-1061
Mailing address
6018 CORNERSTONE CT, GRANDVILLE, MI 49418
(616) 340-1061
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
—
MA
Other
Enumeration date
07/21/2006
Last updated
04/06/2023
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