Christa Wallace

NPI #1457984080 in Tulsa, Oklahoma

Provider Information

NPI Number: 1457984080
Entity Type: Individual
Name: Christa Wallace
Gender: Not Specified
Sole Proprietor: Yes
Primary Specialty: Behavior Technician
Enumeration Date: Feb 21, 2020
Last Updated: Oct 22, 2023

Practice Location

Address: 4908 S SHERIDAN RD
City: Tulsa
State: Oklahoma
ZIP Code: 74145-5712
Phone: (918) 984-9153

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Behavior Technician	106S00000X	Primary

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