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Individual

MRS. JULIE JENKS KETTMANN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
M.ED.

Contact information

Practice address
2102 E 38TH ST, DAVENPORT, IA 52807-1135
(563) 359-4049
Mailing address
1392 WOOLRIDGE DR, CORALVILLE, IA 52241-3026
(309) 255-5281

Taxonomy

Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
00996
IA
101YP2500X
Professional Counselor
IL

Other

Enumeration date
03/15/2007
Last updated
07/08/2007
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