NPI | 1356548671 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 101Y00000X Counselor |
Additional Taxonomies | 103K00000X Behavior Analyst (Licence: CA 1356548671) |
171M00000X Case Manager/Care Coordinator (Licence: CA 1356548671) | |
Enumeration Date | 2007-06-29 |
Last Update Date | 2020-04-20 |