| NPI | 1558026096 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP1600X Counselor, Pastoral |
| Additional Taxonomies | 103K00000X Behavior Analyst |
| 106E00000X Assistant Behavior Analyst | |
| 106H00000X Marriage & Family Therapist | |
| Enumeration Date | 2021-10-31 |
| Last Update Date | 2021-10-31 |