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
State
Georgia
ZIP Code
30214-4056
Phone
(770) 954-8988

Specialties & Taxonomy Codes

Specialty
Behavior Technician

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