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Individual
MRS. SHARICE N WALLACE
Active
Individual
MRS. SHARICE N WALLACE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MA CCC-SLP
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
015733-1
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
015733-1
SPEECH LANGUAGE PATHOLOGIST NYS LICENSE
NY
Enumeration date
12/17/2008
Last updated
12/12/2016
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