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Organization
BRAVE BEHAVIOR LLC
Active
Organization
BRAVE BEHAVIOR LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SHAVONNE SHORTER (CEO)
(979) 257-6129
Entity
Organization
Contact information
Practice address
912 SOUTH ST, EL CAMPO, TX 77437-3810
(979) 257-6129
Mailing address
912 SOUTH ST, EL CAMPO, TX 77437-3810
(979) 257-6129
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
—
—
261QH0700X
Hearing and Speech Clinic/Center
—
—
261QX0100X
Occupational Medicine Clinic/Center
—
—
Other
Enumeration date
10/11/2022
Last updated
10/11/2022
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