Tyjaih Wallace
NPI #1023721610 in Fayetteville, Georgia
Provider Information
- NPI Number
- 1023721610
- Entity Type
- Individual
- Name
- Tyjaih Wallace
- Gender
- Not Specified
- Sole Proprietor
- No
- Primary Specialty
- Behavior Technician
- Enumeration Date
- Dec 29, 2022
- Last Updated
- Dec 29, 2022
Practice Location
- Address
- 126 PAVILION PKWY
- City
- Fayetteville
- State
- Georgia
- ZIP Code
- 30214-4056
- Phone
- (770) 954-8988
Specialties & Taxonomy Codes
| Specialty |
|---|
| Behavior Technician |
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