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1750021978
JOHNNY WALLACE
GARDENA, CA
NPI
1750021978
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
103K00000X Behavior Analyst
Enumeration Date
2022-03-29
Last Update Date
2022-03-29
Business Address
JOHNNY WALLACE
1411 W 190TH ST
GARDENA, CA 90248-4324
Phone number: 562-210-6842
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Mailing Address
JOHNNY WALLACE
1411 W 190TH ST
GARDENA, CA 90248-4324
Phone number:
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