| NPI | 1740483031 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103T00000X Psychologist (Licence: OH P6785) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: OH 6785) |
| 106E00000X Assistant Behavior Analyst | |
| Enumeration Date | 2007-06-06 |
| Last Update Date | 2022-10-26 |