Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Dominique Waller

Individual provider Behavior Technician · NPI 1790529568

Dominique Waller is a Behavior Technician in Roanoke, Virginia. Licensed in Virginia. Registered with an NPI since 2024.

Licensed in
VA
In the registry since
2024

Practice location Address checks out

214 Westside Blvd Apt 6
Roanoke, VA 24017
Phone: (540) 278-9002
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Behavior Technician (primary) Taxonomy 106S00000X · Licence RBT-23-281401 (VA)

Record details

NPI number1790529568
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorNo
NPI enumeratedJune 25, 2024
Last updated in NPPESJune 25, 2024
Certification dateJune 25, 2024
Mailing address214 Westside Blvd, Apt. 6, Roanoke, VA 24017

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