Organization
TIMOTHY U KETTERSON PHD PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
NORMA A BOX (OFFICE MANAGER)
(352) 337-0551
Entity
Organization
Contact information
Practice address
4965 SW 91ST TER, SUITE A, GAINESVILLE, FL 32608-8149
(352) 337-0551
(352) 374-2166
Mailing address
4965 SW 91ST TER, SUITE A, GAINESVILLE, FL 32608-8149
(352) 337-0551
(352) 374-2166
Taxonomy
Speciality
Code
Description
License number
State
103TC1900X
Counseling Psychologist
Primary
PY7453
FL
Other
Enumeration date
04/25/2008
Last updated
05/29/2008
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