Individual
ELLE MARIE WALLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
13414 NE 23RD AVE UNIT 326, VANCOUVER, WA 98686-3052
(360) 218-6232
Mailing address
7108 S KANNER HWY, STUART, FL 34997-7462
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
WA
106S00000X
Behavior Technician
—
—
Other
Enumeration date
10/01/2024
Last updated
10/01/2024
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