Kayla Jo Wallace

NPI #1003457110 in Auburn, Michigan

Provider Information

NPI Number: 1003457110
Entity Type: Individual
Name: Kayla Jo Wallace
Gender: Not Specified
Sole Proprietor: Yes
Primary Specialty: Behavior Technician
Enumeration Date: Oct 1, 2019
Last Updated: May 27, 2025

Practice Location

Address: 4600 GARFIELD ROAD
City: Auburn
State: Michigan
ZIP Code: 48611
Phone: (892) 266-3415

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Behavior Technician	106S00000X	Primary

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