Provider Demographics
NPI:1528567534
Name:GALAN GOICOCHEA, ROSALIA (BCBA)
Entity Type:Individual
Prefix:
First Name:ROSALIA
Middle Name:
Last Name:GALAN GOICOCHEA
Suffix:
Gender:F
Credentials:BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2701 SW 10TH ST APT 112
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33135-4631
Mailing Address - Country:US
Mailing Address - Phone:786-307-6370
Mailing Address - Fax:
Practice Address - Street 1:2701 SW 10TH ST APT 112
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33135-4631
Practice Address - Country:US
Practice Address - Phone:786-307-6370
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-02-05
Last Update Date:2021-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL0-19-10642106E00000X
106S00000X
FL1-21-48477103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
No106E00000XBehavioral Health & Social Service ProvidersAssistant Behavior Analyst
No106S00000XBehavioral Health & Social Service ProvidersBehavior Technician