Individual
LAKEN WALLAR
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1086 THORNROSE WAY, WAKE FOREST, NC 27587-6947
(662) 610-1756
Mailing address
1086 THORNROSE WAY, WAKE FOREST, NC 27587-6947
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
1-22-60616
NC
Other
Enumeration date
08/03/2022
Last updated
08/03/2022
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