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Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.

AUTUMN VICTORIA WALLACE

Active

AUTUMN VICTORIA WALLACE is a Behavior Technician healthcare provider located in GONZALES, Louisiana. NPI 1770148587 is currently active in the NPPES registry. Verify at CMS.

Behavior Technician · GONZALES, LA

Registration Details

NPI Number
1770148587
Provider Type
Individual
Gender
Female
NPI Issued
May 7, 2019 (7.2576066872647 yrs)
Last Updated
May 7, 2019

Practice Information

Address
1028 E WORTHY ST
GONZALES, LA, 707374367
Browse LA providers · Browse ZIP 70737
Phone
5043999851
Fax
9852610311
Primary Specialty
Behavior Technician
106S00000X

Other Behavior Technician Providers in GONZALES, LA

Name Credential NPI
BRITTANY B ALDRIDGE 1093168460
TYESHA MICHELLE LOVE 1447724265
HARLEY AVIS CANTILLO 1801355573
TRENECIA JORDAN 1376107946
ASHLEY WAGUESPACK 1780241471
OLEVIA TENNILLE GUIDRY 1356995591
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.