Individual
LATOYA WALLACE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1730 WILLIAMS TRACE BLVD STE H, SUGAR LAND, TX 77478-4055
(281) 978-6056
Mailing address
13311 LAKE RIDGE DR, RICHMOND, TX 77469-8509
(346) 538-9084
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
RBT-23-307352
TX
Other
Enumeration date
11/13/2023
Last updated
11/13/2023
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