Individual
MS. SHELLY LYNN KETELHUT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MSE, NCC, CSAC
Contact information
Practice address
1936B ALGOMA BLVD, OSHKOSH, WI 54901-2104
(920) 232-0208
(844) 270-4612
Mailing address
1936B ALGOMA BLVD, OSHKOSH, WI 54901-2104
(920) 232-0208
(844) 270-4612
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
15566-130
WI
101YP2500X
Professional Counselor
4498-125
WI
Other
Enumeration date
08/19/2008
Last updated
10/08/2021
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