DAVID SCOTT KETCHAM

RAWLINS, WY
NPI1609180041
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy101YA0400X Counselor, Addiction (Substance Use Disorder)
(Licence: WY  CAP -19)
Enumeration Date2010-07-27
Last Update Date2010-07-27
Business Address
-- DAVID SCOTT KETCHAM BA
143 SONORA CT
RAWLINS, WY 82301-5115
Phone number: 307-324-7156
Mailing Address
-- DAVID SCOTT KETCHAM BA
143 SONORA CT
RAWLINS, WY 82301-5115
Phone number: 307-324-7156