Individual
KAITLYN KETCHUM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3621 MARION LN, LAS CRUCES, NM 88012-7579
(575) 520-6074
Mailing address
3621 MARION LN, LAS CRUCES, NM 88012-7579
(575) 520-6074
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
07/26/2023
Last updated
07/26/2023
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