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Individual
MALCOLM L BROADNAX
Active
Individual
MALCOLM L BROADNAX
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
LCA3486
MD
101YM0800X
Mental Health Counselor
LGP14898
MD
Other
Enumeration date
06/11/2024
Last updated
06/11/2025
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