Individual
BLAKE KETTERER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
3095 KETTERING BLVD, MORAINE, OH 45439-1983
(937) 293-8300
Mailing address
3095 KETTERING BLVD, MORAINE, OH 45439-1983
(937) 293-8300
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
171M00000X
Case Manager/Care Coordinator
—
—
Other
Enumeration date
08/15/2024
Last updated
08/15/2024
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