| NPI | 1588897144 |
|---|---|
| Entity Type | Individual |
| Gender | N/A |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103T00000X Psychologist (Licence: NY 0180321) |
| Additional Taxonomies | 103K00000X Behavior Analyst (Licence: NY 1084058) |
| Enumeration Date | 2009-08-31 |
| Last Update Date | 2009-08-31 |