| NPI | 1265947261 |
|---|---|
| Former Name | BRENDON GAEL O'HARA |
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC2200X Psychologist Clinical Child & Adolescent |
| Additional Taxonomies | 103K00000X Behavior Analyst |
| 103TB0200X Psychologist Cognitive & Behavioral | |
| 273R00000X Psychiatric Unit | |
| 103TM1800X Psychologist Mental Retardation & Developmental Disabilities | |
| Enumeration Date | 2017-12-13 |
| Last Update Date | 2017-12-13 |