| NPI | 1235679895 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103K00000X Behavior Analyst (Licence: UT 3107107-2506) |
| Additional Taxonomies | 101Y00000X Counselor |
| 104100000X Social Worker (Licence: UT 3107107-3503) | |
| Enumeration Date | 2017-03-01 |
| Last Update Date | 2024-06-17 |