MRS. Alicia Wallace, M.A. CCC-SLP
NPI #1265751457 in Saint James, New York
Provider Information
- NPI Number
- 1265751457
- Entity Type
- Individual
- Name
- MRS. Alicia Wallace, M.A. CCC-SLP
- Gender
- Not Specified
- Sole Proprietor
- Yes
- Primary Specialty
- Speech-Language Pathologist
- Credential
- M.A. CCC-SLP
- Enumeration Date
- May 27, 2010
- Last Updated
- Oct 31, 2014
Practice Location
- Address
- 7 PONDVIEW
- City
- Saint James
- State
- New York
- ZIP Code
- 11780-3164
- Phone
- (631) 741-1743
Specialties & Taxonomy Codes
| Specialty |
|---|
| Speech-Language Pathologist |
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