| Doctor Name: | MICHAEL BYRNE KELLOGG |
| NPI Number: | 1023089059 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | LMHC, A.T.R. |
| License Number: | MH 6448 |
| Business Practice Address: | 701 E 5th St Saint Cloud, FL - 347693024 |
| Business Phone Number: | 4078919130 |
| Business Fax Number: | |
| Mailing Address: | 701 E 5th St, SAINT CLOUD |
| State: | FL |
| Postal Code: | 347693024 |
| Phone Number: | 4078919130 |
| Fax Number: | |
| NPI Enumeration Date: | 01/28/2006 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YM0800X |
| License Number: | MH 6448 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | FL |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Mental Health |
| Taxonomy Definition: | |