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

Lillian Renee Wallis

Individual provider Behavior Technician · NPI 1639009046

Lillian Renee Wallis is a Behavior Technician in Mishawaka, Indiana. Practices as a sole proprietor. Registered with an NPI since 2026.

In the registry since
2026

Practice location Address checks out

3838 N Main St
Mishawaka, IN 46545-3100
Phone: (888) 982-5228
Show map & directions

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

Specialties & licences

Behavior Technician (primary) Taxonomy 106S00000X

Record details

NPI number1639009046
Entity typeIndividual (Type 1)
GenderNot disclosed
Sole proprietorYes
NPI enumeratedMay 20, 2026
Last updated in NPPESMay 20, 2026
Certification dateMay 19, 2026
Mailing address55245 Timothy Rd, New Carlisle, IN 46552-9669

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