NPI | 1063059095 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 101YM0800X Counselor, Mental Health |
Additional Taxonomies | 103K00000X Behavior Analyst |
171W00000X Contractor | |
Enumeration Date | 2019-12-10 |
Last Update Date | 2019-12-10 |