Individual
LINDSAY CONSTANCE WALLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
BCBA
Contact information
Practice address
530 W THOMAS ST STE C, MILLEDGEVILLE, GA 31061-2744
(478) 451-0557
Mailing address
530 W THOMAS ST STE C, MILLEDGEVILLE, GA 31061-2744
(478) 451-0557
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
1-20-40658
GA
Other
Enumeration date
02/13/2020
Last updated
02/13/2020
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