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Khaira-Nisaa Wallace
NPI 1417818113 · Behavior Technician · Charlotte, NC
Khaira-Nisaa Wallace is a Behavior Technician provider in Charlotte, NC (NPI 1417818113).
Provider details
- NPI number
- 1417818113
- Entity type
- Individual
- Primary specialty
- Behavior TechnicianBehavioral Health & Social Service Providers
- Sex
- Female
- Sole proprietor
- Yes
- License
- RBT-24-398908 (NC)
Specialties & taxonomies
Behavioral Health & Social Service Providers
Profile Score
Established profile(53/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
Under 1 yr in registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
1300 Baxter St Ste 450
Charlotte, NC 28204-3026
Phone: (704) 366-1075
Street-level locationGet directions
Mailing address
404 Minglewood Dr Unit 7108
Charlotte, NC 28262-0064
Registry dates
- Enumerated
- 2025-11-21
- Last updated
- 2025-11-21
- Certified
- 2025-11-21
Frequently asked questions
- What is Khaira-Nisaa Wallace's NPI number?
- Khaira-Nisaa Wallace's National Provider Identifier (NPI) is 1417818113, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What is Khaira-Nisaa Wallace's specialty?
- Khaira-Nisaa Wallace is listed in the NPPES registry with a primary specialty of Behavior Technician (Behavioral Health & Social Service Providers).
- Where is Khaira-Nisaa Wallace located?
- Khaira-Nisaa Wallace's practice location on file with NPPES is 1300 Baxter St Ste 450, Charlotte, NC 28204-3026.
- What is Khaira-Nisaa Wallace's phone number?
- The practice phone number listed in the NPPES registry for Khaira-Nisaa Wallace is (704) 366-1075.
- Is Khaira-Nisaa Wallace's NPI active?
- Yes — Khaira-Nisaa Wallace's NPI (1417818113) is active in the NPPES registry as of the last update on 2025-11-21.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.