NPI | 1235782467 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 106S00000X Behavior Technician |
Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: CA 13078-R) |
Enumeration Date | 2019-07-17 |
Last Update Date | 2024-09-27 |