| NPI | 1629761549 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 106S00000X Behavior Technician |
| Additional Taxonomies | 247200000X Technician, Other |
| 172V00000X Community Health Worker | |
| 251K00000X Public Health or Welfare | |
| 261QC1500X Clinic/Center Community Health | |
| 261QM0855X Clinic/Center Adolescent and Children Mental Health | |
| 374700000X Technician | |
| 261QH0100X Clinic/Center Health Service | |
| 261QM0801X Clinic/Center Mental Health (Including Community Mental Health Center) (Licence: TX 169230772871) | |
| 3747P1801X Technician Personal Care Attendant | |
| 385H00000X Respite Care | |
| 385HR2055X Respite Care Respite Care, Mental Illness, Child | |
| Enumeration Date | 2023-05-26 |
| Last Update Date | 2024-02-04 |