Healthcare Provider Details

I. General information

NPI: 1447806708
Provider Name (Legal Business Name): SHANEXA ESPINAL BCBA, LBA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/13/2019
Last Update Date: 12/03/2025
Certification Date: 12/03/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2511 UNION ST APT 6D
FLUSHING NY
11354-1264
US

IV. Provider business mailing address

1704 OCEAN AVE APT 6C
BROOKLYN NY
11230-5780
US

V. Phone/Fax

Practice location:
  • Phone: 646-204-5999
  • Fax:
Mailing address:
  • Phone: 305-877-0502
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number004602
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: