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Individual
KURT C. BLACKKETTER
Active
Individual
KURT C. BLACKKETTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LPC
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
67378
TX
Other
Enumeration date
09/18/2012
Last updated
09/18/2012
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