NPI | 1073165122 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 106S00000X Behavior Technician (Licence: FL RBT-19-91278) |
Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: FL 5732) |
373H00000X Day Training/Habilitation Specialist | |
Enumeration Date | 2019-07-09 |
Last Update Date | 2019-07-09 |