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

Nicole L Wallace, IS

Individual provider Assistant Behavior Analyst · NPI 1083446405

Nicole L Wallace, IS is an Assistant Behavior Analyst in Idaho Falls, Idaho. Practices as a sole proprietor. Registered with an NPI since 2024.

In the registry since
2024

Practice location Address checks out

2185 Koro Ave
Idaho Falls, ID 83404-6226
Phone: (520) 233-3382
Show map & directions

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

Specialties & licences

Assistant Behavior Analyst (primary) Taxonomy 106E00000X

Record details

NPI number1083446405
Entity typeIndividual (Type 1)
GenderFemale
Credentials IS
Sole proprietorYes
NPI enumeratedAugust 14, 2024
Last updated in NPPESAugust 14, 2024
Certification dateAugust 14, 2024

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