| NPI | 1578870119 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: NV MI0436) |
| Additional Taxonomies | 103K00000X Behavior Analyst |
| 103TR0400X Psychologist, Rehabilitation | |
| 171M00000X Case Manager/Care Coordinator | |
| Enumeration Date | 2010-09-02 |
| Last Update Date | 2014-08-11 |