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1265263131
LEONA C WALLACE
ZACHARY, LA
NPI
1265263131
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
106S00000X Behavior Technician
(Licence: LA 12065646)
Enumeration Date
2024-08-12
Last Update Date
2024-08-12
Business Address
LEONA C WALLACE
1215 INDEPENDENCE BLVD
ZACHARY, LA 70791-7390
Phone number: 225-286-1547
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Mailing Address
LEONA C WALLACE
996 ROYAL MARCO WAY
MARCO ISLAND, FL 34145-1829
Phone number:
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