Individual
MRS. BEVERLY JEAN KETCHUM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
C.P.D. C.L.D.
Contact information
Practice address
4725 W 163RD ST, LAWNDALE, CA 90260-2822
(424) 240-6505
Mailing address
4756 W 163RD ST, LAWNDALE, CA 90260-2821
(424) 240-6505
Taxonomy
Speciality
Code
Description
License number
State
374J00000X
Doula
Primary
2012-257
CA
Other
Enumeration date
10/10/2018
Last updated
10/10/2018
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