Individual
TAMAR L KETCHUM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3507 N UNIVERSITY AVE STE 225, PROVO, UT 84604-6635
(317) 800-0340
Mailing address
3507 N UNIVERSITY AVE STE 225, PROVO, UT 84604-6635
(801) 960-9355
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
13648326-3502
UT
Other
Enumeration date
07/22/2024
Last updated
07/22/2024
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