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Individual
KETRA A FORRY
Active
Individual
KETRA A FORRY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
BA
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
PC008070
PA
103K00000X
Behavior Analyst
—
—
Other
Enumeration date
01/05/2010
Last updated
03/17/2015
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