IndividualActive
Avery Ketteman, RBT
NPI 1942087580 · Behavior Technician · Herrin, IL
Provider details
- NPI number
- 1942087580
- Entity type
- Individual
- Primary specialty
- Behavior TechnicianBehavioral Health & Social Service Providers
- Credential
- RBT
- Sex
- Female
- Sole proprietor
- No
Specialties & taxonomies
Behavioral Health & Social Service Providers
Practice location
3022 S Park Ave Ste B
Herrin, IL 62948-3721
Phone: (217) 525-8332
Approximate (ZIP-level) locationGet directions
Mailing address
5220 6th Street Frontage Rd E Ste 1700
Springfield, IL 62703-5771
Registry dates
- Enumerated
- 2023-09-08
- Last updated
- 2023-09-08
- Certified
- 2023-09-08
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.