Shanita Shan Grace
Individual provider Active NPI Behavior Technician · Dania, FL
NPI 1023705407 · NPPES record last updated Apr 18, 2023
Key facts
- NPI
- 1023705407
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Behavior Technician 106S00000X
- Practice address
- 506 NW 3Rd St Apt 2
Dania, FL 33004-2701 - Phone
- (754) 273-0262
- NPI assigned
- Apr 18, 2023
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Behavior Technician | 106S00000X | FL | Yes |
Addresses
Primary practice location
506 NW 3Rd St Apt 2
Dania, FL 33004-2701
Mailing address
506 NW 3Rd St Apt 2
Dania, FL 33004-2701
Phone (754) 273-0262
Other providers in Dania, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 18, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.