Individual
KATHRYN PAIGE WALLACE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CCC-SLP
Contact information
Practice address
8390 SIX FORKS RD STE 104, RALEIGH, NC 27615-3060
(919) 247-4551
Mailing address
610 GRAND CENTRAL STA, APEX, NC 27502-2472
(980) 328-2400
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
30002017
NC
Other
Enumeration date
06/23/2023
Last updated
06/23/2023
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