Individual
SANDRA PATRICIA BURGOS MORA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
BCBA
Contact information
Practice address
10713 SERAPE RD, CHARLOTTE, NC 28277-3800
(704) 890-8196
Mailing address
10713 SERAPE RD, CHARLOTTE, NC 28277-3800
(704) 890-8196
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
1300
NC
Other
Enumeration date
05/13/2021
Last updated
05/03/2024
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