| NPI | 1629667936 |
|---|---|
| Entity Type | Individual |
| Gender | N/A |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103K00000X Behavior Analyst (Licence: TX 7947) |
| Additional Taxonomies | 106S00000X Behavior Technician (Licence: TX RBT-21-151248) |
| Enumeration Date | 2021-01-12 |
| Last Update Date | 2025-01-10 |