NPI | 1841763422 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 103TB0200X Psychologist, Cognitive & Behavioral |
Additional Taxonomies | 106S00000X Behavior Technician (Licence: FL RBT-18-73414) |
Enumeration Date | 2019-01-07 |
Last Update Date | 2024-01-29 |