Nicole L Wallace, I.S.
NPI #1083446405 in Idaho Falls, Idaho
Provider Information
- NPI Number
- 1083446405
- Entity Type
- Individual
- Name
- Nicole L Wallace, I.S.
- Gender
- Not Specified
- Sole Proprietor
- Yes
- Primary Specialty
- Assistant Behavior Analyst
- Credential
- I.S.
- Enumeration Date
- Aug 14, 2024
- Last Updated
- Aug 14, 2024
Practice Location
- Address
- 2185 KORO AVE
- City
- Idaho Falls
- State
- Idaho
- ZIP Code
- 83404-6226
- Phone
- (520) 233-3382
Specialties & Taxonomy Codes
| Specialty |
|---|
| Assistant Behavior Analyst |
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