| NPI | 1801693114 |
|---|---|
| Professional Name | COACH B WILLIS |
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 175T00000X Peer Specialist |
| Additional Taxonomies | 101Y00000X Counselor |
| 171400000X | |
| Enumeration Date | 2025-02-26 |
| Last Update Date | 2025-02-26 |