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Individual
BRENT RICHARD IDE
Active
Individual
BRENT RICHARD IDE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LSCSW
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
4374
KS
1041C0700X
Clinical Social Worker
7784
KS
Other
Enumeration date
07/09/2010
Last updated
10/15/2026
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