| NPI | 1447838248 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: IN 88002003A) |
| Additional Taxonomies | 106S00000X Behavior Technician (Licence: IN RBT-19-76474) |
| Enumeration Date | 2021-04-01 |
| Last Update Date | 2023-08-01 |