Individual
ASHLEY NICOLE WALLACE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
5145 SILVER CREEK DR APT 180, HOUSTON, TX 77017-6031
(832) 880-8673
Mailing address
5145 SILVER CREEK DR APT 180, HOUSTON, TX 77017-6031
(832) 880-8673
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
35030195
TX
Other
Enumeration date
04/28/2026
Last updated
04/28/2026
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