Semone Wallace
Behavior Technician in Farmington Hills, MI. Individual provider (NPI-1).
NPI number1174205181
StatusActive
Last updated in NPPESAug 1, 2023
Details
- NPI
- 1174205181
- Entity type
- Individual (NPI-1)
- Name
- Semone Wallace
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Aug 1, 2023
- Certification date
- Aug 1, 2023
- Last updated
- Aug 1, 2023
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 106S00000X | Behavior Technician | – | – | Yes |
Practice location
27777 Inkster Rd Ste 100Farmington Hills, MI 48334-5312
Phone 248-299-0030
Mailing address
27777 Inkster Rd Ste 100Farmington Hills, MI 48334-5312
Phone 248-299-0030
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