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Individual

MRS. ELAINE ANTHONY KETRING

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
LCPC

Contact information

Practice address
404 N PERSHING ST, ENERGY, IL 62933-3530
(618) 942-2516
(618) 942-2516
Mailing address
208 N PERSHING ST UNIT 333, ENERGY, IL 62933-6118
(618) 942-2516
(618) 942-2516

Taxonomy

Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
180-003332
IL

Other

Enumeration date
11/05/2007
Last updated
09/13/2012
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