IndividualActive
Adam Wallace
NPI 1790477479 · Behavior Technician · Las Cruces, NM
Provider details
- NPI number
- 1790477479
- Entity type
- Individual
- Primary specialty
- Behavior TechnicianBehavioral Health & Social Service Providers
- Sex
- Male
- Sole proprietor
- No
Specialties & taxonomies
Behavioral Health & Social Service Providers
- Mental Health Counselor101YM0800X
Behavioral Health & Social Service Providers
Practice location
1250 Hillrise Cir
Las Cruces, NM 88011-4741
Phone: (575) 288-1881
Fax: (575) 288-1889
Approximate (ZIP-level) locationGet directions
Mailing address
1250 Hillrise Cir
Las Cruces, NM 88011-4741
Additional practice locations (1)
- 1255 Country Club Rd Ste DSanta Teresa, NM 88008-9707Phone: (575) 288-1881Fax: (575) 288-1889
Registry dates
- Enumerated
- 2023-05-22
- Last updated
- 2024-05-08
- Certified
- 2024-05-08
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.