Organization
THE SHAPING ACADEMY FOR BEHAVIORAL DEVELOPMENT
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. YANIVIS GONZALEZ BCBA, LMHC (CEO)
(305) 562-4683
Entity
Organization
Contact information
Practice address
12930 SW 128TH ST, SUITE 204A1, MIAMI, FL 33186-6038
(305) 562-4683
(866) 517-3411
Mailing address
12930 SW 128TH ST, SUITE 204A1, MIAMI, FL 33186-6038
(305) 562-4683
(866) 517-3411
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
1-12-10380
FL
251S00000X
Community/Behavioral Health Agency
Primary
MH 11547
FL
Other
Enumeration date
03/03/2008
Last updated
09/23/2013
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