NPI 1053144378

Angel Diane Wallace

Practitioner Day Training/Habilitation Specialist Kent, OH

Practice location

Address: 366 Suzanne Dr, Kent, OH 44240-1932
Phone: (270) 784-0144

Registered specialties

Day Training/Habilitation Specialist Primary

Nursing Service Related Providers Taxonomy 373H00000X

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Registry record

NPI: 1053144378
Entity type: Individual
Sex (as registered): Female
NPI issued: 22 Aug 2024
Record last updated: 22 Aug 2024

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.