| NPI | 1598479727 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 106S00000X Behavior Technician (Licence: FL CBHT.0100373) |
| Additional Taxonomies | 171M00000X Case Manager/Care Coordinator (Licence: FL CBHCM103830) |
| 106S00000X Behavior Technician (Licence: FL RBT-23-300122) | |
| Enumeration Date | 2023-01-11 |
| Last Update Date | 2023-09-29 |