RANDALL THOMAS WALLACE
NPI 1801735790
Behavior Technician in Traverse City, MI

Active since March 26, 2026
10781 E CHERRY BEND RD, TRAVERSE CITY, MI 49684(231) 492-8420 Get Directions Write a Review

NPPES record last updated: March 26, 2026. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Randall Thomas Wallace NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

RANDALL THOMAS WALLACE (NPI 1801735790) is an individual behavior technician in Traverse City, Michigan and active in the NPI registry since March 2026.

NPPES Registry Identity

NPI1801735790
Entity TypeIndividualMale
Primary Taxonomy106S00000X
Provider Legal NameRANDALL THOMAS WALLACE
Location Address10781 E CHERRY BEND RDTraverse City, MI 49684-5249
Mailing Address2435 Slocum RdKingsley, MI 49649-9691
Sole ProprietorNo
Enumeration DateMarch 26, 2026
NPPES CertifiedMarch 26, 2026
NPI 1801735790 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyBehavior TechnicianBehavioral Health & Social Service Providers
Taxonomy Code106S00000X
Definition
The behavior technician is a paraprofessional who practices under the close, ongoing supervision of a behavior analyst or assistant behavior analyst certified by the Behavior Analyst Certification Board and/or credentialed by a state (such as through licensure). The behavior technician is primarily responsible for the implementation of components of behavior-analytic treatment plans developed by the supervisor. That may include collecting data on treatment targets and conducting certain types of behavioral assessments (e.g., stimulus preference assessments). The behavior technician does not design treatment or assessment plans or procedures but provides services as assigned by the supervisor responsible for his or her work.
10781 E CHERRY BEND RD, Traverse City, MI 49684

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

Behavior Analyst
10781 E CHERRY BEND RD
TRAVERSE CITY, MI 49684
Behavior Technician
10781 E CHERRY BEND RD
TRAVERSE CITY, MI 49684
Behavior Technician
10781 E CHERRY BEND RD
TRAVERSE CITY, MI 49684
Behavior Analyst
10781 E CHERRY BEND RD
TRAVERSE CITY, MI 49684
Behavior Technician
10781 E CHERRY BEND RD
TRAVERSE CITY, MI 49684
Behavior Technician
10781 E CHERRY BEND RD
TRAVERSE CITY, MI 49684
Behavior Technician
10781 E CHERRY BEND RD
TRAVERSE CITY, MI 49684
Behavior Technician
10781 E CHERRY BEND RD
TRAVERSE CITY, MI 49684

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 Randall Wallace's NPI number?

The NPI number for Randall Wallace is 1801735790. It was assigned to this individual provider in the NPPES registry on March 26, 2026.

Where is Randall Wallace located?

Randall Wallace practices at 10781 E Cherry Bend Rd, Traverse City, MI 49684. The listed phone number is (231) 492-8420.

What is Randall 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 Randall Wallace was last updated on March 26, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 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.