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Individual
RAYMOND PENNER
Active
Individual
RAYMOND PENNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LSCSW
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
7410
KS
1041C0700X
Clinical Social Worker
05301
KS
Other
Enumeration date
06/05/2009
Last updated
06/09/2021
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