| NPI | 1295288181 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103K00000X Behavior Analyst (Licence: WA 61079809) |
| Additional Taxonomies | 101Y00000X Counselor (Licence: WA CG60675292) |
| 106E00000X Assistant Behavior Analyst (Licence: WA AB60967560) | |
| Enumeration Date | 2016-07-27 |
| Last Update Date | 2020-09-15 |