NPI | 1710214507 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: OR c4796) |
Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: OR c4796) |
103K00000X Behavior Analyst | |
171M00000X Case Manager/Care Coordinator | |
Enumeration Date | 2009-11-16 |
Last Update Date | 2018-06-16 |