| Shine On Academy Llc | |
|
1105 Fort Clarke Blvd Apt 307 Gainesville FL 32606-7123 | |
| (352) 474-0372 | |
| Not Available |
| Full Name | Shine On Academy Llc |
|---|---|
| Speciality | Behavior Analyst |
| Location | 1105 Fort Clarke Blvd Apt 307, Gainesville, Florida |
| Authorized Official Name and Position | Cynthia Gordon (OWNER, BCBA) |
| Authorized Official Contact | 3524740372 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Shine On Academy Llc 1105 Fort Clarke Blvd Apt 307 Gainesville FL 32606-7123 Ph: (352) 474-0372 | Shine On Academy Llc 1105 Fort Clarke Blvd Apt 307 Gainesville FL 32606-7123 Ph: (352) 474-0372 |
| NPI Number | 1578160818 |
|---|---|
| Provider Enumeration Date | 10/08/2020 |
| Last Update Date | 10/08/2020 |
| Certification Date | 10/08/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1578160818 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103K00000X | Behavior Analyst | (* (Not Available)) | Primary |
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