Individual
CAROLYN N KETCHEL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
151 MARY ESTHER BLVD, SUITE 302, MARY ESTHER, FL 32569-1972
(850) 243-1302
(850) 301-0671
Mailing address
PO BOX 7, SHALIMAR, FL 32579-0007
(850) 243-1302
(850) 301-0671
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
SW4709
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
SW 4709
STATE LIENSE
FL
Enumeration date
12/15/2011
Last updated
02/12/2014
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