NPI | 1295744142 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 103K00000X Behavior Analyst (Licence: CO 1-00-0058) |
Additional Taxonomies | 103T00000X Psychologist (Licence: MA 7304) |
103T00000X Psychologist (Licence: NE 575) | |
103T00000X Psychologist (Licence: CO 2277) | |
103TB0200X Psychologist, Cognitive & Behavioral (Licence: 1-00-0058) | |
Enumeration Date | 2006-08-07 |
Last Update Date | 2020-10-27 |