| NPI | 1265667315 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health |
| Additional Taxonomies | 103K00000X Behavior Analyst |
| 174400000X Specialist | |
| Enumeration Date | 2009-05-19 |
| Last Update Date | 2010-07-08 |