NPI | 1518435684 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 103K00000X Behavior Analyst |
Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: LA 011720681) |
Enumeration Date | 2018-11-07 |
Last Update Date | 2024-01-16 |