Individual
MS. KELLEY KETTERMAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
BA, MED
Contact information
Practice address
9702 STONESTREET RD, LOUISVILLE, KY 40272-6808
(833) 510-4357
(866) 460-2997
Mailing address
615 ELSINORE PL STE 200, CINCINNATI, OH 45202-1457
(833) 510-4357
(866) 460-2997
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
273669
KY
101YA0400X
Addiction (Substance Use Disorder) Counselor
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—
Other
Enumeration date
02/01/2016
Last updated
01/12/2022
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