Individual
COURTNEY KETTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
3455 W CRAIG RD STE C, NORTH LAS VEGAS, NV 89032-5119
(702) 518-4337
Mailing address
6905 DIVER AVE, NORTH LAS VEGAS, NV 89084-3103
(310) 409-5882
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1134362056
—
NV
Enumeration date
06/06/2011
Last updated
06/06/2011
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