| NPI | 1184023145 |
|---|---|
| Former Name | MYKEL C WENTZ |
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 175T00000X Peer Specialist |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health |
| Enumeration Date | 2014-08-15 |
| Last Update Date | 2019-10-15 |