Individual
ELIZABETH MARIE WALLACE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
20015 NE LAKIN RD, BATTLE GROUND, WA 98604-9609
(360) 896-3893
Mailing address
20015 NE LAKIN RD, BATTLE GROUND, WA 98604-9609
(360) 896-3893
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
WA
Other
Enumeration date
01/25/2024
Last updated
01/25/2024
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