Individual
ANGELA WALLACE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
550 W 37TH ST STE A, ANDERSON, IN 46013-4004
(888) 454-3324
(888) 616-1637
Mailing address
550 W 37TH ST STE A, ANDERSON, IN 46013-4004
(888) 454-3324
(888) 616-1637
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
1-25-81446
IN
Other
Enumeration date
06/12/2018
Last updated
10/03/2025
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