Individual
MRS. KATHRYN DIANE WALLIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MS/CCC-SLP
Contact information
Practice address
2610 GREYSOLON RD, DULUTH, MN 55812-2306
(218) 349-0589
Mailing address
2610 GREYSOLON RD, DULUTH, MN 55812-2306
(218) 349-0589
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
5644
MN
Other
Enumeration date
09/21/2007
Last updated
09/25/2010
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