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Individual

MS. DEBORAH FAYE KETCHAM

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
LCMHC

Contact information

Practice address
133 BLAKELY RD, SUITE 213, COLCHESTER, VT 05446-4007
(802) 864-3999
Mailing address
133 BLAKELY RD, SUITE 213, COLCHESTER, VT 05446-4007
(802) 864-3999

Taxonomy

Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
0680000576
VT

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1008536
VT
Enumeration date
09/28/2006
Last updated
07/09/2007
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