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1740999184
SHANICE WALLACE
KISSIMMEE, FL
NPI
1740999184
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
106S00000X Behavior Technician
Enumeration Date
2022-11-15
Last Update Date
2022-11-15
Business Address
SHANICE WALLACE Behavior Technician
3831 W VINE ST STE 60
KISSIMMEE, FL 34741-4650
Phone number: 866-311-4617
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Mailing Address
SHANICE WALLACE Behavior Technician
1500 S DOUGLAS RD STE 230
CORAL GABLES, FL 33134-4108
Phone number:
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