| NPI | 1174043954 |
|---|---|
| Entity Type | Individual |
| Gender | N/A |
| Sole Proprietor ? | No |
| Primary Taxonomy | 106S00000X Behavior Technician |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) |
| 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: CA R1247900417) | |
| Enumeration Date | 2017-06-22 |
| Last Update Date | 2022-07-21 |