Individual
AMBER WALLER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
9260 MARKETPLACE DR, MIAMISBURG, OH 45342-4478
(937) 388-5110
Mailing address
3500 DEPAUW BLVD STE 3070, INDIANAPOLIS, IN 46268-6135
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
RBT-16-22081
OH
Other
Enumeration date
11/29/2019
Last updated
11/29/2019
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