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1073264289
YIDEIRA WALLACE
NORTH PORT, FL
NPI
1073264289
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
106S00000X Behavior Technician
(Licence: FL RBT-21-195063)
Enumeration Date
2022-01-10
Last Update Date
2022-01-10
Business Address
Mrs. YIDEIRA WALLACE RBT
4584 FLINT DR
NORTH PORT, FL 34286-6604
Phone number: 786-570-3643
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Mailing Address
Mrs. YIDEIRA WALLACE RBT
4584 FLINT DR
NORTH PORT, FL 34286-6604
Phone number: 786-570-3643
Copy
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