NPI | 1659410686 |
---|---|
Former Name | JAMES LEE WOLFE |
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 175T00000X Peer Specialist (Licence: OR 11-CRM-134) |
Additional Taxonomies | 171M00000X Case Manager/Care Coordinator |
Enumeration Date | 2007-02-06 |
Last Update Date | 2016-12-20 |