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Individual

ADAM KETCHERSIDE

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
LMSW

Contact information

Practice address
10024 OFFICE CENTER AVE STE 100, SAINT LOUIS, MO 63128-1392
(314) 729-7050
(314) 729-0920
Mailing address
900 E LAHARPE ST, KIRKSVILLE, MO 63501-4520
(660) 665-1962
(660) 665-3989

Taxonomy

Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
2014007562
MO

Other

Enumeration date
08/21/2014
Last updated
08/21/2014
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