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1750948337
ELICIA WALLACE
GRAND BLANC, MI
NPI
1750948337
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
106S00000X Behavior Technician
Enumeration Date
2019-05-20
Last Update Date
2019-05-20
Business Address
ELICIA WALLACE
8285 S SAGINAW ST STE 7
GRAND BLANC, MI 48439-2436
Phone number: 810-321-3001
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Mailing Address
ELICIA WALLACE
8285 S SAGINAW ST STE 7
GRAND BLANC, MI 48439-2436
Phone number: 810-321-3001
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