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1780342089
TAKIA WALLACE
AUGUSTA, GA
NPI
1780342089
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
106S00000X Behavior Technician
(Licence: GA RBT-21-195151)
Enumeration Date
2021-12-03
Last Update Date
2021-12-03
Business Address
TAKIA WALLACE
101 ROSSMORE PL
AUGUSTA, GA 30909-5771
Phone number: 706-842-5330
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Mailing Address
TAKIA WALLACE
3736 EXECUTIVE CENTER DR
AUGUSTA, GA 30907-2360
Phone number: 706-842-5330
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