NPI | 1174068613 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 101YM0800X Counselor Mental Health |
Additional Taxonomies | 247200000X Technician, Other |
103K00000X Behavior Analyst | |
Enumeration Date | 2016-12-19 |
Last Update Date | 2020-10-30 |