| NPI | 1821522533 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103K00000X Behavior Analyst (Licence: FL 1-16-23212) |
| Additional Taxonomies | 103K00000X Behavior Analyst (Licence: PA BH007749) |
| 103K00000X Behavior Analyst (Licence: RI LBA00084) | |
| 103K00000X Behavior Analyst (Licence: VA 0133003536) | |
| 103K00000X Behavior Analyst (Licence: MI 7401002218) | |
| Enumeration Date | 2017-04-19 |
| Last Update Date | 2025-07-15 |