Individual
JAMIE KETCHUM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1126 19TH ST, ROCKFORD, IL 61104-3432
(815) 721-2859
Mailing address
1126 19TH ST, ROCKFORD, IL 61104-3432
(815) 721-2859
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
—
—
Other
Enumeration date
01/30/2026
Last updated
01/30/2026
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