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1013516053
DEVESDRA WALLACE
CHARLOTTE, NC
NPI
1013516053
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
106S00000X Behavior Technician
Enumeration Date
2020-10-21
Last Update Date
2020-10-21
Business Address
DEVESDRA WALLACE
1401 E 7TH ST
CHARLOTTE, NC 28204-6300
Phone number: 704-780-4271
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Mailing Address
DEVESDRA WALLACE
11015 EDUCATION WAY APT 2406C
CHARLOTTE, NC 28262-7133
Phone number: 910-823-6159
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