Individual
MRS. KERRY LYNN KETCHALE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
420 SOMERS RD, ELLINGTON, CT 06029-2629
(860) 255-4475
Mailing address
420 SOMERS RD, ELLINGTON, CT 06029-2629
(860) 255-4475
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
005794
CT
Other
Enumeration date
07/20/2010
Last updated
06/22/2024
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