NPI | 1083030217 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 103K00000X Behavior Analyst (Licence: NE 1-16-21607) |
Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: NE 10207) |
Enumeration Date | 2014-03-12 |
Last Update Date | 2024-05-10 |