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Organization

CAROLYN N. KETCHEL, P.A.

Active
Organization subpart
No

Provider details

NPI number
Authorized official
CAROLYN N. KETCHEL LCSW (PRESIDENT)
(850) 243-1302
Entity
Organization

Contact information

Practice address
151 MARY ESTHER BLVD, SUITE 302, MARY ESTHER, FL 32569-1973
(850) 243-1302
(850) 301-0671
Mailing address
PO BOX 7, SHALIMAR, FL 32579-0007
(850) 243-1302
(850) 301-0671

Taxonomy

Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
SW4709
FL

Other

Enumeration date
11/16/2012
Last updated
02/12/2014
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