NPI | 1598479727 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 106S00000X Behavior Technician (Licence: FL RBT-23-300122) |
Additional Taxonomies | 106S00000X Behavior Technician (Licence: FL CBHT.0100373) |
171M00000X Case Manager/Care Coordinator (Licence: FL CBHCM103830) | |
Enumeration Date | 2023-01-11 |
Last Update Date | 2025-09-12 |