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Individual

BARBARA JOYCE WALLACE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
13601 N LITCHFIELD RD STE 124, SURPRISE, AZ 85379-4260
(800) 376-3440
Mailing address
1585 N 113TH AVE STE 102, AVONDALE, AZ 85392-3938
(623) 322-8250

Taxonomy

Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary

Other

Enumeration date
03/27/2024
Last updated
08/15/2024
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