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Individual
RAECHAL LYNN WALLAK
Active
Individual
RAECHAL LYNN WALLAK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.S. CCC-SLP
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
030181
NY
235Z00000X
Speech-Language Pathologist
—
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
06511893
—
NY
Enumeration date
03/11/2019
Last updated
11/02/2022
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