| Success Shaping Llc | |
|
2253 Crossbow St Minneola FL 34715-9315 | |
| (210) 290-6575 | |
| Not Available |
| Full Name | Success Shaping Llc |
|---|---|
| Speciality | Behavior Analyst |
| Location | 2253 Crossbow St, Minneola, Florida |
| Authorized Official Name and Position | Courtney L Domingue (OWNER) |
| Authorized Official Contact | 2102906575 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Success Shaping Llc 2253 Crossbow St Minneola FL 34715-9315 Ph: (210) 290-6575 | Success Shaping Llc 2253 Crossbow St Minneola FL 34715-9315 Ph: (210) 290-6575 |
| NPI Number | 1073382230 |
|---|---|
| Provider Enumeration Date | 12/28/2023 |
| Last Update Date | 04/22/2024 |
| Certification Date | 04/22/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1073382230 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103K00000X | Behavior Analyst | (* (Not Available)) | Primary |
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