| NPI | 1942180450 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 106S00000X Behavior Technician (Licence: TX RBT-25-460428) |
| Additional Taxonomies | 103TM1800X Psychologist, Intellectual & Developmental Disabilities (Licence: TX 2103697578) |
| 101YM0800X Counselor, Mental Health (Licence: TX 2103697578) | |
| 2084N0600X (Licence: TX 1458428) | |
| Enumeration Date | 2025-09-04 |
| Last Update Date | 2025-09-06 |