| NPI | 1285335125 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 106S00000X Behavior Technician |
| Additional Taxonomies | 225800000X Recreation Therapist |
| 225C00000X Rehabilitation Counselor | |
| 376J00000X Homemaker | |
| 103K00000X Behavior Analyst | |
| 171M00000X Case Manager/Care Coordinator | |
| Enumeration Date | 2023-03-16 |
| Last Update Date | 2023-03-16 |