NPI | 1205230828 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: PA PC007806) |
Additional Taxonomies | 103K00000X Behavior Analyst (Licence: PA BH000550) |
Enumeration Date | 2014-10-09 |
Last Update Date | 2014-10-09 |