Organization
MEANINGFUL CHANGE LEARNING SERVICES, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SHANE KNOLL BCBA (CEO)
(508) 665-8044
Entity
Organization
Contact information
Practice address
2892 PUEBLO BONITO, SANTA FE, NM 87507-2549
(508) 733-6392
Mailing address
2892 PUEBLO BONITO, SANTA FE, NM 87507-2549
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
1-16-21909
NM
Other
Enumeration date
04/03/2016
Last updated
06/09/2016
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