| NPI | 1285961276 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103K00000X Behavior Analyst (Licence: FL BCBA-1-20-41288) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: FL MH 10015) |
| Enumeration Date | 2009-11-11 |
| Last Update Date | 2024-10-28 |