NPI | 1104220987 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: WA LH60526071) |
Additional Taxonomies | 103K00000X Behavior Analyst |
Enumeration Date | 2014-10-22 |
Last Update Date | 2024-07-10 |