| NPI | 1346920162 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | YEHOUSHUA TYBERG Owner 631-507-7643 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103K00000X Behavior Analyst |
| Additional Taxonomies | 106S00000X Behavior Technician |
| 251S00000X Community/Behavioral Health | |
| Enumeration Date | 2023-07-18 |
| Last Update Date | 2023-12-21 |