| NPI | 1598109878 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: TX 70551) |
| Additional Taxonomies | 103K00000X Behavior Analyst (Licence: TX 1-13-13287) |
| Enumeration Date | 2013-04-17 |
| Last Update Date | 2024-06-04 |