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1407367162
ANTOINE WALLACE
COLUMBIA, MD
NPI
1407367162
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
106S00000X Behavior Technician
Enumeration Date
2017-10-20
Last Update Date
2017-10-20
Business Address
ANTOINE WALLACE
6355 WOODSIDE CT
COLUMBIA, MD 21046-1071
Phone number: 410-381-7171
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Mailing Address
ANTOINE WALLACE
6355 WOODSIDE CT
COLUMBIA, MD 21046-1071
Phone number:
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