| NPI | 1871259366 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: HI MFT-805) |
| Additional Taxonomies | 103K00000X Behavior Analyst (Licence: HI BA-610) |
| Enumeration Date | 2021-11-09 |
| Last Update Date | 2023-07-26 |