| NPI | 1568983278 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103K00000X Behavior Analyst (Licence: 1-24-76816) |
| Additional Taxonomies | 106E00000X Assistant Behavior Analyst (Licence: 0-19-10578) |
| 106S00000X Behavior Technician (Licence: 18-53232) | |
| Enumeration Date | 2017-07-03 |
| Last Update Date | 2024-10-24 |