Basic Information
| Provider Information | |||||||||
| NPI: | 1669055778 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | SHAPING STEPS ABA, PLLC | ||||||||
| LastName: | |||||||||
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| OtherOrganizationName: | SHAPING STEPS ABA | ||||||||
| OtherOrganizationType: | 3 | ||||||||
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| Mailing Information | |||||||||
| Address1: | 12708 LEE PARK LN | ||||||||
| Address2: | |||||||||
| City: | AUSTIN | ||||||||
| State: | TX | ||||||||
| PostalCode: | 787322365 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9795998295 | ||||||||
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| Practice Location | |||||||||
| Address1: | 12708 LEE PARK LN | ||||||||
| Address2: | |||||||||
| City: | AUSTIN | ||||||||
| State: | TX | ||||||||
| PostalCode: | 787322365 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9795998295 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 05/05/2021 | ||||||||
| LastUpdateDate: | 07/19/2021 | ||||||||
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| AuthorizedOfficialLastName: | BOTELLO GARCIA | ||||||||
| AuthorizedOfficialFirstName: | ALMA | ||||||||
| AuthorizedOfficialMiddleName: | XOCHITL | ||||||||
| AuthorizedOfficialTitleorPosition: | OWNER | ||||||||
| AuthorizedOfficialTelephone: | 5122223544 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | MRS. | ||||||||
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| AuthorizedOfficialCredential: | M.ED., BCBA., LBA | ||||||||
| NPICertificationDate: | 07/19/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 103K00000X | Y | 193400000X SINGLE SPECIALTY GROUP | Behavioral Health & Social Service Providers | Behavioral Analyst |
No ID Information.