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Individual

GIANCARLO OJEDA SANJURJO

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
BCABA

Contact information

Practice address
200 S HARBOR CITY BLVD STE 401, MELBOURNE, FL 32901-1389
(321) 259-1662
Mailing address
200 S HARBOR CITY BLVD STE 401, MELBOURNE, FL 32901-1389
(321) 259-1662

Taxonomy

Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
MH26318
FL
106E00000X
Assistant Behavior Analyst
Primary
0-20-11159
FL
106S00000X
Behavior Technician
RBT-17-32968
FL
247200000X
Other Technician

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
022064200
FL
Enumeration date
10/27/2016
Last updated
04/27/2026
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