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1790322840
TIM WALLACE
ALAMEDA, CA
NPI
1790322840
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
106S00000X Behavior Technician
Enumeration Date
2019-12-09
Last Update Date
2019-12-09
Business Address
TIM WALLACE
1025 ATLANTIC AVE STE 101
ALAMEDA, CA 94501-1188
Phone number: 510-268-8120
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Mailing Address
TIM WALLACE
850 RUSSELL AVE APT D1
SANTA ROSA, CA 95403-2106
Phone number: 707-843-0735
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