| NPI | 1568051654 |
|---|---|
| Entity Type | Individual |
| Gender | N/A |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103K00000X Behavior Analyst (Licence: TX 6335) |
| Additional Taxonomies | 106S00000X Behavior Technician (Licence: TX RBT-19-4847-166391) |
| Enumeration Date | 2021-01-13 |
| Last Update Date | 2023-10-10 |