| NPI | 1649877937 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225C00000X Rehabilitation Counselor |
| Additional Taxonomies | 103K00000X Behavior Analyst |
| 225C00000X Rehabilitation Counselor | |
| Enumeration Date | 2020-10-08 |
| Last Update Date | 2024-03-01 |