Individual provider · Type 1 NPI

Zakary Russell Wallace, MS, BCBA, LBA

Behavior Analyst · Bowling Green, KY

NPI number 1497319529 Active

Practice location

2427 Russellville Rd
Bowling Green, KY 42101-3980

Call (270) 936-7472 Map

Fax (317) 520-8200

Mailing address

3500 Depauw Blvd Ste 3070
Indianapolis, IN 46268-6135

Specialties and licenses

Taxonomy	Code	License
Behavior Analyst	103K00000X	None listed
Behavior Technician	106S00000X	RBT-19-84856
Behavior Analyst Primary	103K00000X	274223 (KY)

Behavior Analyst: A behavior analyst is qualified by at least a master's degree and Behavior Analyst Certification Board certification and/or a state-issued credential (such as a license) to practice behavior analysis independently. Behavior analysts provide the required supervision to assistant behavior analysts and behavior technicians. A behavior analyst delivers services consistent with the dimensions of applied behavior analysis…

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About NPI 1497319529

Zakary Russell Wallace, MS, BCBA, LBA's National Provider Identifier is 1497319529, issued on Apr 24, 2019. The primary taxonomy on file is Behavior Analyst (103K00000X), and the practice location is in Bowling Green, KY. The record was last updated on Nov 1, 2021.