| NPI | 1316360175 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103K00000X Behavior Analyst |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: NY 010074-01) |
| 101YM0800X Counselor, Mental Health (Licence: FL MH21855) | |
| 101YM0800X Counselor, Mental Health (Licence: NJ 37PC01141400) | |
| 101YP2500X Counselor, Professional (Licence: NJ 37PC01141400) | |
| Enumeration Date | 2014-01-30 |
| Last Update Date | 2025-05-15 |