Individual
ANGENETT WALLACE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RBT
Contact information
Practice address
4559 HEARTLAND DR, RICHTON PARK, IL 60471-2413
(708) 762-2907
Mailing address
4559 HEARTLAND DR, RICHTON PARK, IL 60471-2413
(708) 762-2907
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
IL
Other
Enumeration date
12/01/2025
Last updated
12/01/2025
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