NPI | 1104195650 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: OK 6437) |
Additional Taxonomies | 101Y00000X Counselor |
103K00000X Behavior Analyst | |
Enumeration Date | 2011-12-28 |
Last Update Date | 2017-11-06 |