| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
|
| Primary Taxonomy | 106S00000X Behavior Technician |
| Additional Taxonomies | 103K00000X Behavior Analyst |
| 251B00000X Case Management |
| 251S00000X Community/Behavioral Health |
| 261QC1500X Clinic/Center, Community Health |
| 171400000X Health & Wellness Coach |
| 171M00000X Case Manager/Care Coordinator |
| 247000000X Technician, Health Information |
| 175T00000X Peer Specialist |
| 225800000X Recreation Therapist |
| 225A00000X Music Therapist |
| Enumeration Date | 2023-03-16 |
| Last Update Date | 2023-03-16 |