NPI | 1720212293 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 103K00000X Behavior Analyst |
Additional Taxonomies | 101YM0800X Counselor, Mental Health |
322D00000X Residential Treatment Facility, Emotionally Disturbed Children | |
Enumeration Date | 2009-05-12 |
Last Update Date | 2009-05-12 |