NPI | 1912236084 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 103K00000X Behavior Analyst (Licence: LA 1-12-120168) |
Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: LA 4601) |
103K00000X Behavior Analyst (Licence: LA L-005) | |
Enumeration Date | 2009-12-18 |
Last Update Date | 2017-10-19 |