KENOSHA ARCHIE-WALLACE
NPI 1629902192
Behavior Technician in Statesboro, GA
About Kenosha Archie-wallace NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
KENOSHA ARCHIE-WALLACE (NPI 1629902192) is an individual behavior technician in Statesboro, Georgia and active in the NPI registry since June 2026.
NPPES Registry Identity
Specialties & Licenses
Other Providers at the Same Location NPPES 5
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
Frequently Asked Questions NPPES & CMS
Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.
What is Kenosha Archie-wallace's NPI number?
The NPI number for Kenosha Archie-wallace is 1629902192. It was assigned to this individual provider in the NPPES registry on June 10, 2026.
Where is Kenosha Archie-wallace located?
Kenosha Archie-wallace practices at 2760 Northside Dr W, Statesboro, GA 30458. The listed phone number is (912) 208-2024.
What is Kenosha Archie-wallace's specialty?
The primary specialty registered for this NPI is Behavior Technician with taxonomy code 106S00000X.
When was this NPI record last updated?
The NPPES record for Kenosha Archie-wallace was last updated on June 10, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.