| NPI | 1891533907 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 373H00000X Day Training/Habilitation Specialist |
| Additional Taxonomies | 103TP2701X Psychologist, Group Psychotherapy |
| 106S00000X Behavior Technician | |
| Enumeration Date | 2024-07-15 |
| Last Update Date | 2024-07-15 |