NPI | 1073012993 |
---|---|
Entity Type | Individual |
Gender | N/A |
Sole Proprietor ? | Yes |
Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: DE AC-0010445) |
Additional Taxonomies | 106S00000X Behavior Technician |
Enumeration Date | 2018-02-06 |
Last Update Date | 2024-09-05 |