NPI | 1962153478 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 106S00000X Behavior Technician (Licence: GA RBT-22-199126) |
Additional Taxonomies | 103K00000X Behavior Analyst (Licence: GA 1-25-79144) |
Enumeration Date | 2022-01-16 |
Last Update Date | 2025-02-07 |