NPI | 1225722978 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: FL MH21234) |
Additional Taxonomies | 103K00000X Behavior Analyst |
Enumeration Date | 2023-06-06 |
Last Update Date | 2025-07-29 |