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Organization
SHAPING TO SUCCESS
Active
Organization
SHAPING TO SUCCESS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JEANETTE LOPEZ (CEO)
(832) 656-9774
Entity
Organization
Contact information
Practice address
2287 AZAHAR CT, LEAGUE CITY, TX 77573-3299
(347) 733-2596
Mailing address
2287 AZAHAR CT, LEAGUE CITY, TX 77573-3299
(832) 656-9774
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
—
—
225X00000X
Occupational Therapist
—
—
261QH0700X
Hearing and Speech Clinic/Center
—
—
Other
Enumeration date
04/30/2021
Last updated
04/30/2021
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