| NPI | 1164825642 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103K00000X Behavior Analyst |
| Additional Taxonomies | 101Y00000X Counselor |
| 103K00000X Behavior Analyst (Licence: FL 1-19-39692) | |
| 106E00000X Assistant Behavior Analyst | |
| Enumeration Date | 2014-09-29 |
| Last Update Date | 2025-01-07 |