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1376138123
KIRSTEN WALLACE
COLUMBIA, SC
NPI
1376138123
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
103K00000X Behavior Analyst
Enumeration Date
2021-03-03
Last Update Date
2021-03-03
Business Address
KIRSTEN WALLACE
1505 BLANDING ST
COLUMBIA, SC 29201-2906
Phone number: 803-929-0011
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Mailing Address
KIRSTEN WALLACE
130 FORGE FARM CT
IRMO, SC 29063-2225
Phone number: 803-800-5233
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