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

Tyjaih Wallace

Individual provider Behavior Technician · NPI 1023721610

Tyjaih Wallace is a Behavior Technician in Fayetteville, Georgia. Registered with an NPI since 2022.

In the registry since
2022

Practice location Address checks out

126 Pavilion Pkwy
Fayetteville, GA 30214-4056
Phone: (770) 954-8988
Fax: (317) 520-8200
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 number1023721610
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorNo
NPI enumeratedDecember 29, 2022
Last updated in NPPESDecember 29, 2022
Certification dateDecember 29, 2022
Mailing address3500 Depauw Blvd Ste 3070, Indianapolis, IN 46268-6135

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