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1679276257
SAMUEL ROBERT WALLACE-DOUGLAS
MENIFEE, CA
NPI
1679276257
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
106S00000X Behavior Technician
Enumeration Date
2023-03-23
Last Update Date
2023-03-23
Business Address
SAMUEL ROBERT WALLACE-DOUGLAS
27990 SHERMAN RD
MENIFEE, CA 92585-9155
Phone number: 951-309-9135
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Mailing Address
SAMUEL ROBERT WALLACE-DOUGLAS
5850 GRANITE PKWY STE 600
PLANO, TX 75024-6753
Phone number:
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