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Individual

ELIAGNE SANJURJO SANCHEZ

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
10650 W STATE ROAD 84 STE 206, DAVIE, FL 33324-4235
(954) 634-3636
Mailing address
7556 STIRLING RD APT 222, HOLLYWOOD, FL 33024-1509
(954) 668-5080

Taxonomy

Speciality
Code
Description
License number
State
106E00000X
Assistant Behavior Analyst
FL
106E00000X
Assistant Behavior Analyst
Primary
106S00000X
Behavior Technician
3747P1801X
Personal Care Attendant

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
014641900
FL
Enumeration date
04/16/2015
Last updated
12/26/2022
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