Courtney Wallace

NPI #1457201451 in Edmond, Oklahoma

Provider Information

NPI Number: 1457201451
Entity Type: Individual
Name: Courtney Wallace
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Behavior Technician
Enumeration Date: Jan 29, 2026
Last Updated: Jan 29, 2026

Practice Location

Address: 501 S COLTRANE RD
City: Edmond
State: Oklahoma
ZIP Code: 73034-6714
Phone: (580) 318-9415

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Behavior Technician	106S00000X	Primary

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