| Shape Empower Change | |
|
104 Kronos Ln Cary NC 27513-5339 | |
| (203) 980-1534 | |
| Not Available |
| Full Name | Shape Empower Change |
|---|---|
| Speciality | Behavior Analyst |
| Location | 104 Kronos Ln, Cary, North Carolina |
| Authorized Official Name and Position | Sara Carbone (FOUNDER) |
| Authorized Official Contact | 2039801534 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Shape Empower Change 104 Kronos Ln Cary NC 27513-5339 Ph: (203) 980-1534 | Shape Empower Change 104 Kronos Ln Cary NC 27513-5339 Ph: (203) 980-1534 |
| NPI Number | 1518568351 |
|---|---|
| Provider Enumeration Date | 11/06/2020 |
| Last Update Date | 11/06/2020 |
| Certification Date | 11/06/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1518568351 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103K00000X | Behavior Analyst | (* (Not Available)) | Primary |
| 252Y00000X | Early Intervention Provider Agency | (* (Not Available)) | Secondary |
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