BENJAMIN Z WALLACE

FAIRVIEW HEIGHTS, IL
NPI1205691847
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy106S00000X Behavior Technician
(Licence:   RBT-20-148513)
Enumeration Date2024-02-13
Last Update Date2024-02-13
Business Address
Mr. BENJAMIN Z WALLACE
9106 WEDGEWOOD DR
FAIRVIEW HEIGHTS, IL 62208-1047
Phone number: 903-721-0145
Mailing Address
Mr. BENJAMIN Z WALLACE
9106 WEDGEWOOD DR
FAIRVIEW HEIGHTS, IL 62208-1047
Phone number: 903-721-0145
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