Mr. Benjamin Z Wallace
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 DrFairview Heights, IL 62208-1047
Phone: (903) 721-0145
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Specialties & licences
| Behavior Technician (primary) | Taxonomy 106S00000X · Licence RBT-20-148513 |
|---|
Record details
| NPI number | 1205691847 |
|---|---|
| Entity type | Individual (Type 1) |
| Gender | Male |
| Sole proprietor | Yes |
| NPI enumerated | February 13, 2024 |
| Last updated in NPPES | February 13, 2024 |
| Certification date | February 13, 2024 |
| Mailing address | 9106 Wedgewood Dr, Fairview Heights, IL 62208-1047 |
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