| NPI | 1083114706 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: CA 15822) |
| Additional Taxonomies | 106S00000X Behavior Technician (Licence: CA 00005178) |
| 106S00000X Behavior Technician | |
| 106E00000X Assistant Behavior Analyst | |
| 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: CA R1371851119) | |
| Enumeration Date | 2018-02-19 |
| Last Update Date | 2025-09-16 |