Individual
MRS. JESSICA WALLACE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2900 KNOX SCHOOL RD, ALLIANCE, OH 44601-9021
(330) 938-1122
Mailing address
14277 S MAIN ST, BELOIT, OH 44609-9504
(330) 938-1122
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
2015123
OH
235Z00000X
Speech-Language Pathologist
Primary
SP.12089
OH
Other
Enumeration date
12/01/2014
Last updated
09/10/2019
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