Organization
SHAPING AFFINITY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. JESSIE KERN GIAMMANCHERI BCBA (CLINICAL DIRECTOR)
(985) 414-2491
Entity
Organization
Contact information
Practice address
2525 PINERIDGE ST, THIBODAUX, LA 70301-3976
(985) 414-2491
Mailing address
2525 PINERIDGE ST, THIBODAUX, LA 70301-3976
(985) 414-2491
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
—
—
Other
Enumeration date
12/10/2021
Last updated
12/10/2021
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