| NPI | 1255850525 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | STEPHEN LOUIS DICARLO Credentialing Assistant Manager 855-324-0885 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103K00000X Behavior Analyst |
| Enumeration Date | 2017-09-18 |
| Last Update Date | 2023-03-15 |