Individual
MRS. DONNA JO EMILY WALLIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
203 S WASHINGTON AVE STE 30, SAGINAW, MI 48607-1217
(989) 259-9984
Mailing address
8961 HIGHLAND DR, FREELAND, MI 48623-8717
(989) 259-9984
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
7401001383
MI
103K00000X
Behavior Analyst
—
MI
106S00000X
Behavior Technician
—
—
Other
Enumeration date
08/23/2018
Last updated
08/06/2023
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