Individual
DAVID SCOTT KETCHAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
BA
Contact information
Practice address
143 SONORA CT, RAWLINS, WY 82301-5115
(307) 324-7156
(307) 328-1651
Mailing address
143 SONORA CT, RAWLINS, WY 82301-5115
(307) 324-7156
(307) 328-1651
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
CAP -19
WY
Other
Enumeration date
07/27/2010
Last updated
07/27/2010
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