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

Randall Thomas Wallace

Individual provider Behavior Technician · NPI 1801735790

Randall Thomas Wallace is a Behavior Technician in Traverse City, Michigan. Registered with an NPI since 2026.

In the registry since
2026

Practice location Address checks out

10781 E Cherry Bend Rd
Traverse City, MI 49684-5249
Phone: (231) 492-8420
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 number1801735790
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorNo
NPI enumeratedMarch 26, 2026
Last updated in NPPESMarch 26, 2026
Certification dateMarch 26, 2026
Mailing address2435 Slocum Rd, Kingsley, MI 49649-9691

Other providers in Traverse City