NPI | 1780987966 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: FL MH 11288) |
Additional Taxonomies | 103K00000X Behavior Analyst |
Enumeration Date | 2010-12-10 |
Last Update Date | 2024-06-19 |