| Doctor Name: | DR. JENNIFER W KETNER |
| NPI Number: | 1215049093 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | PSYD |
| License Number: | 015710 |
| Business Practice Address: | 380 Mill Rd Westhampton Beach, NY - 119782063 |
| Business Phone Number: | 6312883969 |
| Business Fax Number: | |
| Mailing Address: | Po Box 195, WESTHAMPTON |
| State: | NY |
| Postal Code: | 119770195 |
| Phone Number: | 6316820265 |
| Fax Number: | |
| NPI Enumeration Date: | 08/31/2006 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 103TC0700X |
| License Number: | 015710 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | NY |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Psychologist |
| Taxonomy Specialization: | Clinical |
| Taxonomy Definition: | |