Individual
MS. EMILY ANNE WALLACE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RBT
Contact information
Practice address
2005 AEROPLAZA DR, COLORADO SPRINGS, CO 80916-4207
(719) 387-7775
Mailing address
4905 HACKAMORE DR N, COLORADO SPRINGS, CO 80918-2632
(719) 387-7775
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
RBT-25-454947
CO
Other
Enumeration date
10/01/2025
Last updated
10/01/2025
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