Individual
KIRA KELLOGG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSW, LMSW
Contact information
Practice address
1355 TERRELL MILL RD SE, MARIETTA, GA 30067-5496
(404) 439-9981
Mailing address
1030 FAYETTEVILLE RD SE, ATLANTA, GA 30316-2921
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
MSW011224
GA
1041C0700X
Clinical Social Worker
Primary
MSW011224
GA
Other
Enumeration date
07/17/2023
Last updated
09/13/2023
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