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1497503353
TIAJA WALLACE
TAMPA, FL
NPI
1497503353
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
106S00000X Behavior Technician
Enumeration Date
2024-05-07
Last Update Date
2024-05-07
Business Address
TIAJA WALLACE
5330 PRIMROSE LAKE CIR
TAMPA, FL 33647-3589
Phone number: 877-823-4283
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Mailing Address
TIAJA WALLACE
745 ORIENTA AVE STE 1011
ALTAMONTE SPRINGS, FL 32701-5675
Phone number: 877-823-4283
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