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

Raven Wallace

Individual provider Behavior Technician · NPI 1417634718

Raven Wallace is a Behavior Technician in Winston Salem, North Carolina. Registered with an NPI since 2023.

In the registry since
2023

Practice location Address checks out

8025 N Point Blvd Ste 100
Winston Salem, NC 27106-3291
Phone: (704) 780-4271
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 number1417634718
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorNo
NPI enumeratedJune 29, 2023
Last updated in NPPESJune 29, 2023
Certification dateJune 29, 2023

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