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1598358426
SAMANDA JUSTINE WALLACE
GASTONIA, NC
NPI
1598358426
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
106S00000X Behavior Technician
Enumeration Date
2021-02-11
Last Update Date
2022-01-26
Business Address
SAMANDA JUSTINE WALLACE
2675 COURT DR
GASTONIA, NC 28054-1478
Phone number: 704-824-7800
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Mailing Address
SAMANDA JUSTINE WALLACE
119 BOLDING ST
GASTONIA, NC 28052-3505
Phone number: 704-685-1733
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