Individual
WILLIE CHARLES BRANTLEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
RECOVERY COACH
Contact information
Practice address
3501 BREWSTER ST, HOUSTON, TX 77026-4446
(512) 293-2526
Mailing address
10106 FONVILLE DR, HOUSTON, TX 77075-3304
(832) 858-3024
Taxonomy
Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
Primary
1011-0319
TX
Other
Enumeration date
06/11/2019
Last updated
06/11/2019
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