NPI | 1801307160 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 103K00000X Behavior Analyst (Licence: FL 1-24-71639) |
Additional Taxonomies | 106S00000X Behavior Technician (Licence: FL 19-82-801) |
Enumeration Date | 2017-10-13 |
Last Update Date | 2025-02-03 |