| NPI | 1437573870 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103K00000X Behavior Analyst (Licence: ND 1-18-33918) |
| Additional Taxonomies | 101YM0800X Counselor Mental Health |
| Enumeration Date | 2014-02-05 |
| Last Update Date | 2022-10-24 |