Individual
JENNIFER KETTENHOVEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
1415 FAIRVIEW ST, OSHKOSH, WI 54901-3101
(920) 526-1027
Mailing address
1415 FAIRVIEW ST, OSHKOSH, WI 54901-3101
(920) 526-1027
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
9759-123
WI
Other
Enumeration date
09/04/2021
Last updated
09/04/2021
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