| NPI | 1336031582 |
|---|---|
| Former Name | BOBBY RAY KITCHEN |
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 175T00000X Peer Specialist (Licence: TX 2083-1124) |
| Additional Taxonomies | 101YA0400X Counselor Addiction (Substance Use Disorder) (Licence: TX 70472) |
| Enumeration Date | 2025-07-21 |
| Last Update Date | 2025-07-21 |