Audrey Ketcham, RBT
Behavior Technician in San Diego, CA. Individual provider (NPI-1).
NPI number1417435546
StatusActive
Last updated in NPPESJul 31, 2018
Details
- NPI
- 1417435546
- Entity type
- Individual (NPI-1)
- Name
- Audrey Ketcham
- Credential
- RBT
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Jul 31, 2018
- Last updated
- Jul 31, 2018
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 106S00000X | Behavior Technician | – | – | Yes |
Practice location
7090 Miratech DrSan Diego, CA 92121-3109
Phone 585-304-6440
Mailing address
7090 Miratech DrSan Diego, CA 92121-3109
Phone 585-304-6440
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