Individual
ASHLEY MARIAH WALLEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3433 BRAMBLETON AVE, ROANOKE, VA 24018-6515
(540) 266-7550
Mailing address
1580 READ MOUNTAIN RD, ROANOKE, VA 24019-5852
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
01/23/2023
Last updated
01/23/2023
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