# MRS. JESSICA WALLACE

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** No

## Provider details

- **NPI number:** 1285031682
- **Gender:** F

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 235Z00000X | Speech-Language Pathologist | 2015123 | OH | — |
| 235Z00000X | Speech-Language Pathologist | SP.12089 | OH | Yes |

## Other

- **Enumeration date:** 12/01/2014
- **Last updated:** 09/10/2019