NPI | 1467941781 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: FL SW18743) |
Additional Taxonomies | 106S00000X Behavior Technician |
Enumeration Date | 2018-05-02 |
Last Update Date | 2021-10-05 |