NPI | 1104192251 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 103K00000X Behavior Analyst (Licence: FL 12582893) |
Additional Taxonomies | 104100000X Social Worker |
106S00000X Behavior Technician (Licence: FL RBT21166286) | |
171M00000X Case Manager/Care Coordinator | |
Enumeration Date | 2012-03-22 |
Last Update Date | 2025-09-17 |