NPI | 1083275739 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 106E00000X Assistant Behavior Analyst (Licence: FL 0-24-15177) |
Additional Taxonomies | 106S00000X Behavior Technician (Licence: FL 1989161) |
Enumeration Date | 2019-06-24 |
Last Update Date | 2024-04-10 |