| NPI | 1356659809 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1041S0200X Social Worker School |
| Additional Taxonomies | 101YM0800X Counselor Mental Health |
| 103K00000X Behavior Analyst | |
| 104100000X Social Worker | |
| Enumeration Date | 2010-09-17 |
| Last Update Date | 2010-09-17 |