Individual provider · Type 1 NPI
Tara Lynn Ketteringham, LCPC
Professional Counselor · Frederick, MD
NPI number
1104389071
Active
Practice location
5412 Old National Pike
Frederick, MD 21702-3640
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Professional Counselor Primary | 101YP2500X | LC12334 (MD) |
| Professional Counselor | 101YP2500X | LGP9228 (MD) |
Professional Counselor: Definition to come...
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About NPI 1104389071
Tara Lynn Ketteringham, LCPC's National Provider Identifier is 1104389071, issued on Apr 9, 2019. The primary taxonomy on file is Professional Counselor (101YP2500X), and the practice location is in Frederick, MD. The record was last updated on Feb 21, 2023.