Individual provider · Type 1 NPI
Antonio Jamaal Wideman, PEER SPECIALIST
Peer Specialist · Mattapan, MA
NPI number
1932835238
Active
Practice location
884 Cummins Hwy Apt 4
Mattapan, MA 02126-2043
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Peer Specialist Primary | 175T00000X | 202222 (MA) |
Peer Specialist: Individuals certified to perform peer support services through a training process defined by a government agency, such as the Department of Veterans Affairs or a state mental health department/certification/licensing authority.
Another provider at this address
About NPI 1932835238
Antonio Jamaal Wideman, PEER SPECIALIST's National Provider Identifier is 1932835238, issued on Jul 28, 2022. The primary taxonomy on file is Peer Specialist (175T00000X), and the practice location is in Mattapan, MA. The record was last updated on Jul 28, 2022.