Individual
DAVID WALLACE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.S. CCC-SLP
Contact information
Practice address
4850 NATOMAS BLVD APT 127M, SACRAMENTO, CA 95835-1266
(209) 479-9966
Mailing address
4850 NATOMAS BLVD APT 127M, SACRAMENTO, CA 95835-1266
(209) 479-9966
Taxonomy
Speciality
Code
Description
License number
State
2355S0801X
Speech-Language Assistant
3499
CA
235Z00000X
Speech-Language Pathologist
Primary
32521
CA
Other
Enumeration date
06/01/2018
Last updated
08/30/2023
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