| NPI | 1578385993 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 106S00000X Behavior Technician |
| Additional Taxonomies | 106S00000X Behavior Technician (Licence: CA BACB1247289) |
| 106E00000X Assistant Behavior Analyst (Licence: CA BACB1247289) | |
| 106H00000X Marriage & Family Therapist | |
| Enumeration Date | 2024-10-28 |
| Last Update Date | 2025-09-30 |