Individual
ALEXANDRA WALLACE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
5050 TAMIAMI TRL N STE B, NAPLES, FL 34103-2853
(239) 351-4787
Mailing address
2360 LAUREL RD E UNIT 10302, NOKOMIS, FL 34275-3571
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
RBT-22-215004
FL
Other
Enumeration date
07/11/2022
Last updated
07/11/2022
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