Healthcare Provider Details

I. General information

NPI: 1184573883
Provider Name (Legal Business Name): SKILLS SHAPE ABA, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/26/2026
Last Update Date: 01/26/2026
Certification Date: 01/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9725 SELTEN WAY STE B
ORLANDO FL
32827-7933
US

IV. Provider business mailing address

7157 NARCOOSSEE RD # 1542
ORLANDO FL
32822-5533
US

V. Phone/Fax

Practice location:
  • Phone: 408-908-0737
  • Fax:
Mailing address:
  • Phone: 408-908-0737
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number State

VIII. Authorized Official

Name: MS. HA THANH THOMAS
Title or Position: LEAD ANALYST, MANAGER
Credential: M.ED, BCBA
Phone: 408-908-0737