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Individual
BROGAN BLACK CROSSETT
Active
Individual
BROGAN BLACK CROSSETT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMLP
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
03090
KS
Other
Enumeration date
01/19/2022
Last updated
04/28/2023
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