| NPI | 1649744038 |
|---|---|
| Other Name | KEVIN SAN JUAN |
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103K00000X Behavior Analyst (Licence: FL 1-21-56167) |
| Additional Taxonomies | 106E00000X Assistant Behavior Analyst (Licence: FL 0-18-9202) |
| Enumeration Date | 2019-01-18 |
| Last Update Date | 2021-12-09 |