Individual
MYRON EDWARD KETTER
Active
Individual
MYRON EDWARD KETTER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LCSW
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
005368
GA
1041C0700X
Clinical Social Worker
10957
SC
1041C0700X
Clinical Social Worker
SW 8551
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
003171972B
—
GA
05
—
1306015656
—
FL
05
—
1306015656
—
GA
05
—
1306015656
—
SC
Enumeration date
02/20/2008
Last updated
02/10/2020
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