| NPI | 1922416304 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 106E00000X Assistant Behavior Analyst |
| Additional Taxonomies | 101Y00000X Counselor |
| 104100000X Social Worker | |
| 106S00000X Behavior Technician | |
| Enumeration Date | 2014-07-29 |
| Last Update Date | 2019-04-24 |