Provider Demographics
NPI:1346787728
Name:SHINING STARS APPLIED BEHAVIOR ANALYSIS CORP.
Entity Type:Organization
Organization Name:SHINING STARS APPLIED BEHAVIOR ANALYSIS CORP.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:KRISTINA
Authorized Official - Middle Name:
Authorized Official - Last Name:FRENCH
Authorized Official - Suffix:
Authorized Official - Credentials:MPA
Authorized Official - Phone:904-755-0646
Mailing Address - Street 1:1844 PENMAN RD
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:32250-3734
Mailing Address - Country:US
Mailing Address - Phone:904-755-0646
Mailing Address - Fax:904-372-7620
Practice Address - Street 1:1844 PENMAN RD
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE BEACH
Practice Address - State:FL
Practice Address - Zip Code:32250-3734
Practice Address - Country:US
Practice Address - Phone:904-755-0646
Practice Address - Fax:904-372-7620
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-01-24
Last Update Date:2017-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health