NPI | 1871903658 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: PA PC008141) |
Additional Taxonomies | 103K00000X Behavior Analyst (Licence: PA BH001643) |
Enumeration Date | 2014-05-02 |
Last Update Date | 2015-05-01 |