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General NPI Number Information
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NPI Number | 1164702692
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Entity Type | Individual
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Provider Name | JASLIN ASHLEY GOICOECHEA BCABA
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Gender | Female
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Dates
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Enumeration Date | 08/29/2011
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Last Update Date | 08/29/2011
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Provider Practice Location Address
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Address Line | 2695 CYPRESS HEAD TRL
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City | OVIEDO
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State | FL
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Zip | 32765-7381
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Country | US
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Telephone | 407-375-8176
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Fax |
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Provider Business Mailing Address
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Address Line | 7945 PALMDALE DR
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City | ORLANDO
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State | FL
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Zip | 32819-7184
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Country | US
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Telephone | 407-716-2388
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103K00000X
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Taxonomy Name | Behavior Analyst
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License Number | 0-11-4156
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License Number State | FL
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