NPI | 1992090328 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: IN 39003998A) |
Additional Taxonomies | 103K00000X Behavior Analyst |
Enumeration Date | 2011-06-14 |
Last Update Date | 2021-07-06 |