Provider Demographics
NPI:1255030292
Name:WARE, JOEL (LIFE COACH)
Entity type:Individual
Prefix:
First Name:JOEL
Middle Name:
Last Name:WARE
Suffix:
Gender:M
Credentials:LIFE COACH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1266 GILLESPIE DR
Mailing Address - Street 2:
Mailing Address - City:PALM HARBOR
Mailing Address - State:FL
Mailing Address - Zip Code:34684-3013
Mailing Address - Country:US
Mailing Address - Phone:727-421-7495
Mailing Address - Fax:
Practice Address - Street 1:1266 GILLESPIE DR
Practice Address - Street 2:
Practice Address - City:PALM HARBOR
Practice Address - State:FL
Practice Address - Zip Code:34684-3013
Practice Address - Country:US
Practice Address - Phone:727-421-7495
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-02-28
Last Update Date:2023-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor