MR. Benjamin Z Wallace
NPI #1205691847 in Fairview Heights, Illinois
Provider Information
- NPI Number
- 1205691847
- Entity Type
- Individual
- Name
- MR. Benjamin Z Wallace
- Gender
- Not Specified
- Sole Proprietor
- Yes
- Primary Specialty
- Behavior Technician
- Enumeration Date
- Feb 13, 2024
- Last Updated
- Feb 13, 2024
Practice Location
- Address
- 9106 WEDGEWOOD DR
- City
- Fairview Heights
- State
- Illinois
- ZIP Code
- 62208-1047
- Phone
- (903) 721-0145
Specialties & Taxonomy Codes
| Specialty |
|---|
| Behavior Technician |
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