NPI | 1063816619 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 103K00000X Behavior Analyst (Licence: FL 1-22-57924) |
Additional Taxonomies | 101YM0800X Counselor, Mental Health |
103K00000X Behavior Analyst | |
106E00000X Assistant Behavior Analyst | |
Enumeration Date | 2014-10-10 |
Last Update Date | 2025-03-14 |