Individual
JORGE LUIS GAMBOA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
BCBA
Contact information
Practice address
525 N TRYON ST STE 1600, CHARLOTTE, NC 28202-0213
(855) 832-6727
Mailing address
525 N TRYON ST STE 1600, CHARLOTTE, NC 28202-0213
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
—
—
Other
Enumeration date
09/28/2017
Last updated
07/09/2021
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