NPI | 1093936494 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: FL MH5813) |
Additional Taxonomies | 103K00000X Behavior Analyst |
Enumeration Date | 2007-05-01 |
Last Update Date | 2016-06-08 |