| NPI | 1821660283 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103K00000X Behavior Analyst |
| Additional Taxonomies | 106E00000X Assistant Behavior Analyst |
| 171M00000X Case Manager/Care Coordinator | |
| 101Y00000X Counselor | |
| Enumeration Date | 2021-07-14 |
| Last Update Date | 2021-07-14 |