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Individual

KAITLIN BRIANNE WALLA

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
27777 INKSTER RD STE 100, FARMINGTON HILLS, MI 48334-5312
(248) 270-8504
Mailing address
27777 INKSTER RD STE 100, FARMINGTON HILLS, MI 48334-5312

Taxonomy

Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
1315
TN
103K00000X
Behavior Analyst
Primary
5564
TX
103K00000X
Behavior Analyst
7401003278
MI
247200000X
Other Technician

Other

Enumeration date
09/17/2019
Last updated
03/23/2026
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