Individual
MS. JANE ELLEN KELLOGG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MA, LPC
Contact information
Practice address
1333 IRIS AVE, BOULDER, CO 80304-2226
(720) 406-3616
Mailing address
3746 ELDORADO SPRINGS DR, BOULDER, CO 80303-9605
(303) 494-3299
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
LPC 1538
CO
Other
Enumeration date
01/04/2007
Last updated
07/08/2007
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