NPI | 1336847458 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 106S00000X Behavior Technician (Licence: TN RBT-22-222937) |
Additional Taxonomies | 175T00000X Peer Specialist (Licence: TN 000-1960) |
175T00000X Peer Specialist (Licence: TN 000-2) | |
390200000X Student in an Organized Health Care Education/Training Program | |
Enumeration Date | 2023-02-17 |
Last Update Date | 2024-05-24 |