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Individual

DR. STACEY ANN KETCHMAN

Active
Sole proprietor

Provider details

NPI number
Gender
F
Credential
PSY.D.

Contact information

Practice address
WOMACK ARMY MEDICAL CENTER, FORT BRAGG, NC 28310-0001
(910) 907-8198
Mailing address
2926 COACHWAY DR, FAYETTEVILLE, NC 28306-8948
(240) 277-3604

Taxonomy

Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
1367
AL

Other

Enumeration date
02/07/2006
Last updated
07/08/2007
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