person
Ryan Kellog
Mental Health Counselor in East Peoria, Illinois
NPI 1114556719

Ryan Kellog is a Mental Health Counselor based in East Peoria, IL and is specialized in Mental Health. Ryan Kellog practices in East Peoria, IL. The NPI Number for Ryan Kellog is 1114556719 and holds a License No. (Illinois).

The current practice location address for Ryan Kellog is 111 W Washington St Ste 203, East Peoria, IL and can be reached out via phone at 309-671-8060.

Location: 111 W Washington St Ste 203, East Peoria, IL, 61611-2532
person
Provider Profile Details
NPI Number
1114556719
Provider Name
Ryan Kellog
Credential
Provider Entity Type
Individual
Gender
Male
Address
111 W Washington St Ste 203, East Peoria, IL, 61611-2532
Phone Number
309-671-8060
Fax Number
Provider Enumeration Date
04/06/2020
Last Update Date
03/10/2024
institution
Provider Business Practice Location Address Details
Address
111 W Washington St Ste 203
City
State
Zip
61611-2532
Phone Number
309-671-8060
Fax Number
person
Provider Business Mailing Address Details
Address
111 W Washington St Ste 203
City
State
Zip
61611-2532
Phone Number
309-671-8060
Fax Number
person
Provider's Taxonomy Details 1
Type
Behavioral Health & Social Service Providers
Classification
Counselor
Speciality
Mental Health
Taxonomy
License No.
()
Definition
Definition to come...
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