Individual
NATHANIEL WALLACE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
412 1ST ST SE, WASHINGTON, DC 20003-1804
(202) 470-4185
Mailing address
412 1ST ST SE, WASHINGTON, DC 20003-1804
(202) 470-4185
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
—
—
Other
Enumeration date
10/01/2013
Last updated
10/01/2013
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