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1114677861
MADELINE WALLACE
TAYLORSVILLE, UT
NPI
1114677861
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
106S00000X Behavior Technician
Enumeration Date
2022-03-25
Last Update Date
2022-03-25
Business Address
MADELINE WALLACE
6013 S REDWOOD RD
TAYLORSVILLE, UT 84123-5220
Phone number: 801-255-5131
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Mailing Address
MADELINE WALLACE
6013 S REDWOOD RD
TAYLORSVILLE, UT 84123-5220
Phone number: 801-255-5131
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