Individual
MS. HOLLY CAUDELL KETNER
Active
Sole proprietor
Provider details
NPI number
Gender
F
Credential
MA, CCC-SLP
Contact information
Practice address
510 CARPENTER AVE, MOORESVILLE, NC 28115-2512
(704) 202-4730
Mailing address
510 CARPENTER AVE, MOORESVILLE, NC 28115-2512
(704) 202-4730
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
1248
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7411866
—
NC
Enumeration date
02/13/2006
Last updated
07/08/2007
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