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1285085597
CARLY KETCHUM
SAN JUAN CAPISTRANO, CA
NPI
1285085597
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
106H00000X Marriage & Family Therapist
(Licence: CA 81406)
Enumeration Date
2016-06-28
Last Update Date
2020-09-10
Business Address
CARLY KETCHUM LMFT
30200 RANCHO VIEJO RD STE D
SAN JUAN CAPISTRANO, CA 92675-1560
Phone number: 949-391-1812
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Mailing Address
CARLY KETCHUM LMFT
47 CORTE VIDRIOSA
SAN CLEMENTE, CA 92673-7009
Phone number: 949-391-1812
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