Provider Demographics
NPI:1720483167
Name:KETCH, JOANNE MARIE (LPC)
Entity Type:Individual
Prefix:MS
First Name:JOANNE
Middle Name:MARIE
Last Name:KETCH
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:2000 WESTBOROUGH DR
Mailing Address - Street 2:APT 924
Mailing Address - City:KATY
Mailing Address - State:TX
Mailing Address - Zip Code:77449-3291
Mailing Address - Country:US
Mailing Address - Phone:281-740-7563
Mailing Address - Fax:
Practice Address - Street 1:16100 CAIRNWAY DR
Practice Address - Street 2:STE 263
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77084-3562
Practice Address - Country:US
Practice Address - Phone:281-740-7563
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-10-28
Last Update Date:2015-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX69353101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional