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

Mr. Benjamin Z Wallace

Individual provider Behavior Technician · NPI 1205691847

Mr. Benjamin Z Wallace is a Behavior Technician in Fairview Heights, Illinois. Practices as a sole proprietor. Registered with an NPI since 2024.

In the registry since
2024

Practice location Address checks out

9106 Wedgewood Dr
Fairview Heights, IL 62208-1047
Phone: (903) 721-0145
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-20-148513

Record details

NPI number1205691847
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorYes
NPI enumeratedFebruary 13, 2024
Last updated in NPPESFebruary 13, 2024
Certification dateFebruary 13, 2024
Mailing address9106 Wedgewood Dr, Fairview Heights, IL 62208-1047

Other providers in Fairview Heights