Willie Charles Brantley, Recovery Coach
Peer Specialist in Houston, TX. Individual provider (NPI-1).
NPI number1295394419
StatusActive
Last updated in NPPESJun 11, 2019
Details
- NPI
- 1295394419
- Entity type
- Individual (NPI-1)
- Name
- Willie Charles Brantley
- Credential
- Recovery Coach
- Sex
- Male
- Sole proprietor
- Yes
- Enumeration date
- Jun 11, 2019
- Last updated
- Jun 11, 2019
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 175T00000X | Peer Specialist | 1011-0319 | TX | Yes |
Practice location
3501 Brewster StHouston, TX 77026-4446
Phone 512-293-2526
Mailing address
10106 Fonville DrHouston, TX 77075-3304
Phone 832-858-3024
Other practice locations
3124 Prospect St
Houston, TX 77004-6209
Houston, TX 77004-6209
Phone 512-293-2526
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