Individual
CHELSIE KETTON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCPC
Contact information
Practice address
2218 CUSTER AVE, ROCKFORD, IL 61103-4374
(815) 847-9197
Mailing address
2218 CUSTER AVE, ROCKFORD, IL 61103-4374
(815) 847-9197
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
180012422
IL
Other
Enumeration date
10/04/2019
Last updated
10/04/2019
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