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Individual
THERESA KETCHUM-FISH
Active
Individual
THERESA KETCHUM-FISH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
6395-125
WI
Other
Enumeration date
09/05/2014
Last updated
03/01/2017
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