| NPI | 1306233226 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103K00000X Behavior Analyst (Licence: 1-13-14618) |
| Additional Taxonomies | 103K00000X Behavior Analyst (Licence: OH COBA.00483) |
| 103K00000X Behavior Analyst | |
| 171M00000X Case Manager/Care Coordinator | |
| Enumeration Date | 2015-04-17 |
| Last Update Date | 2023-07-03 |