Tysean Demarcus Wallace
Tysean Demarcus Wallace is a Behavior Technician in Minnetonka, Minnesota. Practices as a sole proprietor. Registered with an NPI since 2023.
- In the registry since
- 2023
Practice location Address checks out
5501 Feltl Road MinnetonkaMinnetonka, MN 55343
Phone: (952) 746-0222
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Specialties & licences
| Behavior Technician (primary) | Taxonomy 106S00000X |
|---|
Record details
| NPI number | 1972289825 |
|---|---|
| Entity type | Individual (Type 1) |
| Gender | Male |
| Sole proprietor | Yes |
| NPI enumerated | June 26, 2023 |
| Last updated in NPPES | June 26, 2023 |
| Certification date | June 26, 2023 |
| Mailing address | 14301 Ewing Avenue South, Burnsville, Mn 55306, Burnsville, MN 55306 |
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