MR. Antonio Jamaal Wideman, PEER SPECIALIST
NPI #1932835238 in Mattapan, Massachusetts
Provider Information
- NPI Number
- 1932835238
- Entity Type
- Individual
- Name
- MR. Antonio Jamaal Wideman, PEER SPECIALIST
- Gender
- Not Specified
- Sole Proprietor
- Yes
- Primary Specialty
- Peer Specialist
- Credential
- PEER SPECIALIST
- Enumeration Date
- Jul 28, 2022
- Last Updated
- Jul 28, 2022
Practice Location
- Address
- 884 CUMMINS HWY APT 4
- City
- Mattapan
- State
- Massachusetts
- ZIP Code
- 02126-2043
- Phone
- (617) 691-6034
Specialties & Taxonomy Codes
| Specialty |
|---|
| Peer Specialist |
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