Individual
KATHERINE KETTLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
5009 WHISPER WILLOW DR, FAIRFAX, VA 22030-8205
(703) 543-4693
Mailing address
2711 BELLFOREST CT APT 108, VIENNA, VA 22180-7311
(571) 439-6997
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
2204000837
VA
Other
Enumeration date
10/05/2021
Last updated
10/05/2021
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