NPI | 1508138827 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 106S00000X Behavior Technician |
Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: CA P0902091858) |
Enumeration Date | 2012-02-01 |
Last Update Date | 2019-06-03 |