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1376179945
KEIYONNY WALLACE
PLYMOUTH, MI
NPI
1376179945
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
106S00000X Behavior Technician
Enumeration Date
2020-03-16
Last Update Date
2020-03-16
Business Address
KEIYONNY WALLACE
44670 ANN ARBOR RD W STE 130
PLYMOUTH, MI 48170-4085
Phone number: 313-278-4601
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Mailing Address
KEIYONNY WALLACE
44670 ANN ARBOR RD W STE 130
PLYMOUTH, MI 48170-4085
Phone number: 313-278-4601
Copy
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