Provider Demographics
NPI:1194803023
Name:KETTERING, RHONDA MARIE (MS, NCC,LPCCAP)
Entity type:Individual
Prefix:
First Name:RHONDA
Middle Name:MARIE
Last Name:KETTERING
Suffix:
Gender:F
Credentials:MS, NCC,LPCCAP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1322 JUNIPER DR
Mailing Address - Street 2:
Mailing Address - City:ROCK SPRINGS
Mailing Address - State:WY
Mailing Address - Zip Code:82901-6409
Mailing Address - Country:US
Mailing Address - Phone:307-352-6677
Mailing Address - Fax:
Practice Address - Street 1:2001 DEWAR DR
Practice Address - Street 2:SUITE 270
Practice Address - City:ROCK SPRINGS
Practice Address - State:WY
Practice Address - Zip Code:82901-5773
Practice Address - Country:US
Practice Address - Phone:307-382-3058
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-11-01
Last Update Date:2016-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WY071101YA0400X
WY970101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)