| NPI | 1902341886 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 106E00000X Assistant Behavior Analyst (Licence: FL 0-02-0585) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: FL MH 4695) |
| Enumeration Date | 2016-12-30 |
| Last Update Date | 2016-12-30 |