Audrey Lucille Wallace
Audrey Lucille Wallace is a Behavior Technician in Jerseyville, Illinois. Licensed in Illinois. Registered with an NPI since 2024.
- Licensed in
- IL
- In the registry since
- 2024
Practice location Address checks out
26034 Cemetery RdJerseyville, IL 62052-6385
Phone: (618) 535-2112
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Pin is approximate — placed at the ZIP-code centre, not the exact door.
Specialties & licences
| Behavior Technician (primary) | Taxonomy 106S00000X (IL) |
|---|
Record details
| NPI number | 1285460097 |
|---|---|
| Entity type | Individual (Type 1) |
| Gender | Female |
| Sole proprietor | No |
| NPI enumerated | September 9, 2024 |
| Last updated in NPPES | September 9, 2024 |
| Certification date | September 9, 2024 |
| Mailing address | 26034 Cemetery Rd, Jerseyville, IL 62052-6385 |
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