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1811694870
KIYOSIA WALLACE
VIRGINIA BEACH, VA
NPI
1811694870
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
106S00000X Behavior Technician
Additional Taxonomies
106S00000X Behavior Technician
Enumeration Date
2023-02-10
Last Update Date
2023-05-03
Business Address
KIYOSIA WALLACE
780 LYNNHAVEN PKWY STE 400
VIRGINIA BEACH, VA 23452-7332
Phone number: 877-418-2978
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Mailing Address
KIYOSIA WALLACE
350 FAIRWAY DR STE 101
DEERFIELD BEACH, FL 33441-1834
Phone number: 877-418-2978
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