| NPI | 1316695448 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 106E00000X Assistant Behavior Analyst (Licence: FL BACB1071283) |
| Additional Taxonomies | 106S00000X Behavior Technician (Licence: FL BACB1071283) |
| 171M00000X Case Manager/Care Coordinator | |
| Enumeration Date | 2022-03-17 |
| Last Update Date | 2024-08-06 |