Individual
TOMMY RACHEL KETCHESIDE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MHPP
Contact information
Practice address
1104 N COLLEGE ST, HUNTSVILLE, AR 72740-9672
(479) 750-2020
(479) 750-8967
Mailing address
1104 N COLLEGE ST, HUNTSVILLE, AR 72740-9672
(479) 750-2020
(479) 750-8967
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
247200000X
Other Technician
—
—
Other
Enumeration date
09/17/2008
Last updated
08/08/2014
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