NPI | 1609363506 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: NC 12518A) |
Additional Taxonomies | 103K00000X Behavior Analyst |
Enumeration Date | 2018-04-16 |
Last Update Date | 2023-07-07 |