Individual
MS. ANGELA M BOGUE-GILMORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCMFT
Contact information
Practice address
2509 N LOCH LOMOND COURT, WICHITA, KS 67228
(316) 631-1280
(316) 631-1422
Mailing address
2509 N LOCH LOMOND CT, WICHITA, KS 67228
(316) 631-1280
(316) 631-1422
Taxonomy
Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
Primary
267
KS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
393645
BLUE CROSS BLUE SHIELD ID
KS
Enumeration date
02/07/2007
Last updated
07/08/2007
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