LIA R KETTENIS M.D.
Individual Provider (NPI-1)
Active
Psychiatry & Neurology, Child & Adolescent Psychiatry
Provider Information
- NPI Number
1346459146- Provider Type
- Individual Provider (NPI-1)
- Credentials
- M.D.
- Status
- Active
Contact & Location
- Address
- 645 S ROGERS ST, BLOOMINGTON, IN, 474032353
- Phone
- (812) 269-5092
Specialties & Taxonomies
Psychiatry & Neurology, Child & Adolescent Psychiatry
Primary License: IN #01063824A
Psychiatry & Neurology, Psychiatry
License: IN #01063824A