| NPI | 1831661982 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 106E00000X Assistant Behavior Analyst (Licence: NC A3030) |
| Additional Taxonomies | 101Y00000X Counselor |
| 106S00000X Behavior Technician (Licence: NC BACB1013718) | |
| Enumeration Date | 2018-12-28 |
| Last Update Date | 2025-07-30 |