| NPI | 1063816619 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103K00000X Behavior Analyst |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health |
| 106E00000X Assistant Behavior Analyst | |
| Enumeration Date | 2014-10-10 |
| Last Update Date | 2022-11-23 |