NPI | 1427454636 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 103K00000X Behavior Analyst (Licence: CA 1-15-18144) |
Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: CA 74661) |
Enumeration Date | 2014-11-15 |
Last Update Date | 2015-04-01 |