Ishmiel Wallace
Ishmiel Wallace is a Behavior Technician in Garden Grove, California. Registered with an NPI since 2022.
- In the registry since
- 2022
Practice location Address checks out
12465 Lewis St Ste 102Garden Grove, CA 92840-4658
Phone: (855) 223-7123
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Pin is approximate — placed at the ZIP-code centre, not the exact door.
Specialties & licences
| Behavior Technician (primary) | Taxonomy 106S00000X |
|---|
Record details
| NPI number | 1629709373 |
|---|---|
| Entity type | Individual (Type 1) |
| Gender | Male |
| Sole proprietor | No |
| NPI enumerated | June 23, 2022 |
| Last updated in NPPES | June 23, 2022 |
| Certification date | June 23, 2022 |
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