NPI | 1740584218 |
---|---|
Former Name | NATHANIEL CORNELIUS SCOTT |
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 106S00000X Behavior Technician |
Additional Taxonomies | 172V00000X Community Health Worker |
261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) (Licence: CA 171m00000x) | |
Enumeration Date | 2010-12-27 |
Last Update Date | 2024-11-20 |