| NPI | 1598438590 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 106S00000X Behavior Technician |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: OH C.2305659) |
| Enumeration Date | 2021-07-27 |
| Last Update Date | 2025-11-17 |