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1811754948
CONCHITA WALLACE
SAVANNAH, GA
NPI
1811754948
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
106S00000X Behavior Technician
(Licence: GA RBT-24-331396)
Enumeration Date
2024-03-05
Last Update Date
2024-03-05
Business Address
CONCHITA WALLACE
3 JOHNSTON ST
SAVANNAH, GA 31405-5502
Phone number: 706-842-5330
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Mailing Address
CONCHITA WALLACE
PO BOX 2567
AUGUSTA, GA 30903-2567
Phone number: 706-842-5330
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