| NPI | 1700226321 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103K00000X Behavior Analyst |
| Additional Taxonomies | 101YP1600X Counselor Pastoral |
| 101YP2500X Counselor Professional | |
| 101YP2500X Counselor Professional | |
| Enumeration Date | 2013-06-27 |
| Last Update Date | 2013-06-27 |