| NPI | 1376168716 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103K00000X Behavior Analyst (Licence: MI 7401002283) |
| Additional Taxonomies | 103K00000X Behavior Analyst |
| 106S00000X Behavior Technician (Licence: IN RBT-20-121771) | |
| 106S00000X Behavior Technician | |
| 101YM0800X Counselor Mental Health | |
| Enumeration Date | 2020-06-11 |
| Last Update Date | 2023-12-12 |