Individual
KALEY KETTERING
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
1630 30TH ST, BOULDER, CO 80301-1044
(303) 673-9990
Mailing address
1630 30TH ST BOULDER, SUITE A PMB 496, BOULDER, CO 80301
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
CSW.09924672
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
CSW.09924672
DORA
CO
Enumeration date
01/22/2018
Last updated
05/30/2018
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