| Shaping Affinity Llc | |
|
2525 Pineridge St Thibodaux LA 70301-3976 | |
| (985) 414-2491 | |
| Not Available |
| Full Name | Shaping Affinity Llc |
|---|---|
| Speciality | Behavior Analyst |
| Location | 2525 Pineridge St, Thibodaux, Louisiana |
| Authorized Official Name and Position | Jessie Kern Giammancheri (CLINICAL DIRECTOR) |
| Authorized Official Contact | 9854142491 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Shaping Affinity Llc 2525 Pineridge St Thibodaux LA 70301-3976 Ph: (985) 414-2491 | Shaping Affinity Llc 2525 Pineridge St Thibodaux LA 70301-3976 Ph: (985) 414-2491 |
| NPI Number | 1699434258 |
|---|---|
| Provider Enumeration Date | 12/10/2021 |
| Last Update Date | 12/10/2021 |
| Certification Date | 12/10/2021 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1699434258 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103K00000X | Behavior Analyst | (* (Not Available)) | Primary |
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