Individual
REESE WALLACE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
9100 W 74TH ST, MERRIAM, KS 66204-4004
(913) 676-2000
Mailing address
9100 W 74TH ST, MERRIAM, KS 66204-4004
(913) 676-2000
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
RBT-25-497953
KS
Other
Enumeration date
12/11/2025
Last updated
12/11/2025
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