NPI | 1740838028 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 103K00000X Behavior Analyst (Licence: UT 1-24-76876) |
Additional Taxonomies | 101YM0800X Counselor, Mental Health |
106S00000X Behavior Technician | |
Enumeration Date | 2019-08-29 |
Last Update Date | 2024-10-31 |