Individual
MICHELLE LYNN KETTERER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1330 HOLLINS ST, SAINT LOUIS, MO 63135-1244
(314) 521-7769
Mailing address
1330 HOLLINS ST, SAINT LOUIS, MO 63135-1244
(314) 521-7769
Taxonomy
Speciality
Code
Description
License number
State
222Q00000X
Developmental Therapist
Primary
—
—
Other
Enumeration date
10/24/2012
Last updated
10/24/2012
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