Issis Wallace
NPI #1306604319 in Eastpointe, Michigan
Provider Information
- NPI Number
- 1306604319
- Entity Type
- Individual
- Name
- Issis Wallace
- Gender
- Not Specified
- Sole Proprietor
- No
- Primary Specialty
- Behavior Technician
- Enumeration Date
- Mar 13, 2024
- Last Updated
- Mar 13, 2024
Practice Location
- Address
- 22851 LEXINGTON AVE
- City
- Eastpointe
- State
- Michigan
- ZIP Code
- 48021-1990
- Phone
- (586) 218-8570
Specialties & Taxonomy Codes
| Specialty |
|---|
| Behavior Technician |
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