Individual
MELISSA ANN KETTERL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LBSW
Contact information
Practice address
212 W. CALEDONIA AVE, HILLSBORO, ND 58045-0190
(701) 636-5220
(701) 636-5221
Mailing address
P.O. BOX 190, HILLSBORO, ND 58045-0190
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
ND
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1467934
—
ND
Enumeration date
04/04/2024
Last updated
04/04/2024
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