Organization
THE SHAPING ACADEMY FOR BEHAVIORAL DEVELOPMENT
Active
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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