| NPI | 1417665019 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 106E00000X Assistant Behavior Analyst |
| Additional Taxonomies | 103K00000X Behavior Analyst |
| 104100000X Social Worker | |
| 171M00000X Case Manager/Care Coordinator | |
| 171WH0202X Contractor Home Modifications | |
| 172A00000X Driver | |
| Enumeration Date | 2022-11-11 |
| Last Update Date | 2022-11-11 |