NPI | 1023508785 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 103K00000X Behavior Analyst (Licence: FL BCBA-1-25-81978) |
Additional Taxonomies | 103K00000X Behavior Analyst (Licence: FL 1-25-81978) |
106S00000X Behavior Technician | |
Enumeration Date | 2018-05-17 |
Last Update Date | 2025-08-07 |