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1417635335
ANTHONY JUSTIN WALLACE
KENT, WA
NPI
1417635335
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
106S00000X Behavior Technician
Enumeration Date
2023-07-10
Last Update Date
2023-07-10
Business Address
ANTHONY JUSTIN WALLACE
8725 S 212TH ST BLDG E
KENT, WA 98031-1921
Phone number: 425-658-3017
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Mailing Address
ANTHONY JUSTIN WALLACE
8725 S 212TH ST
KENT, WA 98031-1921
Phone number:
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